Cargando…

Incidental detection of colorectal lesions on (18) F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients

Background and study aims  Further diagnostics of incidental colorectal lesions on (18) F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is questionable. Therefore, we aimed to evaluate the clinical importance of incidentally detected colorectal lesions on FDG-PET...

Descripción completa

Detalles Bibliográficos
Autores principales: Kousgaard, Sabrina Just, Gade, Michael, Petersen, Lars Jelstrup, Thorlacius-Ussing, Ole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2020
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671755/
https://www.ncbi.nlm.nih.gov/pubmed/33269303
http://dx.doi.org/10.1055/a-1266-3308
_version_ 1783610988486983680
author Kousgaard, Sabrina Just
Gade, Michael
Petersen, Lars Jelstrup
Thorlacius-Ussing, Ole
author_facet Kousgaard, Sabrina Just
Gade, Michael
Petersen, Lars Jelstrup
Thorlacius-Ussing, Ole
author_sort Kousgaard, Sabrina Just
collection PubMed
description Background and study aims  Further diagnostics of incidental colorectal lesions on (18) F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is questionable. Therefore, we aimed to evaluate the clinical importance of incidentally detected colorectal lesions on FDG-PET/CT. Patients and methods  In the North Denmark Region, a retrospective study was performed among 19,987 patients who had an FDG-PET/CT from January 2006 to December 2015. Among these patients, we identified patients with a colonoscopy within 12 months from the PET/CT scan and a description of incidental colorectal PET-avid lesions on the PET/CT. PET findings were compared with colonoscopy-detected lesions and eventually histopathology. Results  Incidental PET-avid lesions were observed in 549 patients. Colonoscopy revealed lesions in 457 (83 %), among whom 338 patients had a final histopathological diagnosis. Malignant and premalignant lesions were found in 297 patients (54 % among patients with a PET-avid lesion). The lesions were cancer in 76 patients and adenoma in 221 patients of whom 30 had high-grade and 191 low-grade adenomas. The findings changed patient management in 166 cases (30 % of all patients with a PET-avid lesion). A colonoscopy-based surveillance program was initiated for 80 % of patients with high-grade adenoma. No patients with PET-avid lesions but normal colonoscopy developed colorectal cancer during 3 years of observation (median observation time 7 years). Conclusions  Incidental colorectal FDG uptake was infrequently observed, but when present, it was associated with a high rate of malignant or premalignant lesions. Our results indicate that patients with incidental colorectal FDG uptake should be referred to diagnostic work-up including colonoscopy.
format Online
Article
Text
id pubmed-7671755
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Georg Thieme Verlag KG
record_format MEDLINE/PubMed
spelling pubmed-76717552020-12-01 Incidental detection of colorectal lesions on (18) F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients Kousgaard, Sabrina Just Gade, Michael Petersen, Lars Jelstrup Thorlacius-Ussing, Ole Endosc Int Open Background and study aims  Further diagnostics of incidental colorectal lesions on (18) F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is questionable. Therefore, we aimed to evaluate the clinical importance of incidentally detected colorectal lesions on FDG-PET/CT. Patients and methods  In the North Denmark Region, a retrospective study was performed among 19,987 patients who had an FDG-PET/CT from January 2006 to December 2015. Among these patients, we identified patients with a colonoscopy within 12 months from the PET/CT scan and a description of incidental colorectal PET-avid lesions on the PET/CT. PET findings were compared with colonoscopy-detected lesions and eventually histopathology. Results  Incidental PET-avid lesions were observed in 549 patients. Colonoscopy revealed lesions in 457 (83 %), among whom 338 patients had a final histopathological diagnosis. Malignant and premalignant lesions were found in 297 patients (54 % among patients with a PET-avid lesion). The lesions were cancer in 76 patients and adenoma in 221 patients of whom 30 had high-grade and 191 low-grade adenomas. The findings changed patient management in 166 cases (30 % of all patients with a PET-avid lesion). A colonoscopy-based surveillance program was initiated for 80 % of patients with high-grade adenoma. No patients with PET-avid lesions but normal colonoscopy developed colorectal cancer during 3 years of observation (median observation time 7 years). Conclusions  Incidental colorectal FDG uptake was infrequently observed, but when present, it was associated with a high rate of malignant or premalignant lesions. Our results indicate that patients with incidental colorectal FDG uptake should be referred to diagnostic work-up including colonoscopy. Georg Thieme Verlag KG 2020-12 2020-11-17 /pmc/articles/PMC7671755/ /pubmed/33269303 http://dx.doi.org/10.1055/a-1266-3308 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Kousgaard, Sabrina Just
Gade, Michael
Petersen, Lars Jelstrup
Thorlacius-Ussing, Ole
Incidental detection of colorectal lesions on (18) F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients
title Incidental detection of colorectal lesions on (18) F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients
title_full Incidental detection of colorectal lesions on (18) F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients
title_fullStr Incidental detection of colorectal lesions on (18) F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients
title_full_unstemmed Incidental detection of colorectal lesions on (18) F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients
title_short Incidental detection of colorectal lesions on (18) F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients
title_sort incidental detection of colorectal lesions on (18) f-fdg-pet/ct is associated with high proportion of malignancy: a study in 549 patients
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671755/
https://www.ncbi.nlm.nih.gov/pubmed/33269303
http://dx.doi.org/10.1055/a-1266-3308
work_keys_str_mv AT kousgaardsabrinajust incidentaldetectionofcolorectallesionson18ffdgpetctisassociatedwithhighproportionofmalignancyastudyin549patients
AT gademichael incidentaldetectionofcolorectallesionson18ffdgpetctisassociatedwithhighproportionofmalignancyastudyin549patients
AT petersenlarsjelstrup incidentaldetectionofcolorectallesionson18ffdgpetctisassociatedwithhighproportionofmalignancyastudyin549patients
AT thorlaciusussingole incidentaldetectionofcolorectallesionson18ffdgpetctisassociatedwithhighproportionofmalignancyastudyin549patients