Browse > Article

Colonic Uptake Patterns of F-18-FDG PET in Asymptomatic Adults: Comparison with Colonoscopic Findings  

Pai, Moon-Sun (Department of Radiology, College of Medicine, Ewha Womans University)
Cho, Yoo-Kyung (Department of Gastroenterology, College of Medicine, Ewha Womans University)
Jung, Sung-Ae (Department of Gastroenterology, College of Medicine, Ewha Womans University)
Shim, Ki-Nam (Department of Gastroenterology, College of Medicine, Ewha Womans University)
Lee, Hong-Soo (Department of Family Medicine, College of Medicine, Ewha Womans University)
Publication Information
The Korean Journal of Nuclear Medicine / v.39, no.1, 2005 , pp. 15-20 More about this Journal
Abstract
Purpose: Physiologic intestinal FDG uptake is frequently observed in asymptomatic individuals for cancer screening FDG PET Colonic FDG accumulation is a well-known confusing findings that interfere true cancer detection or cause false positive. The aim of this study was to evaluate the pattern and intensity of colonic uptake in whole body FDG PET in asymptomatic healthy adults and to correlate them with colonoscopic findings. Materials and Methods: We reviewed retrospectively 64 subjects (age: 27-87, M:F=31:33) who underwent both FDG PET and colonoscopy for cancer screening. FDG uptake patterns were classified as focal, segmental and diffuse. Maximum SUV were measured. The PET results were compared with colonoscopic and histologic findings. Results: In 13 patients FDG bowel uptake was interpreted as focal, in 17 patients as segmental and in 34 patients as diffuse uptake. Six adenomas (17.6%, average diameter=5.0 mm) were found in diffuse pattern, 7 adenomas (41.1%, 5.6 mm) in segmental and 4 adenomas and 1 adenocarcinoma (38.5%, 16.4 mm) in focal uptake pattern. In patients with focal uptake, four were non-adenomatous pathologic lesions (30.8%, 2 intestinal tuberculosis, 2 mucosal ulcer). There is no difference of mean SUV between patients with adenoma and with negative colonoscopic results in each group of intestinal FDG pattern (Diffuse: $1.7{\pm}0.1\;vs.\;1.9{\pm}0.5$, Segmental: $4.8{\pm}3.6\;vs.\;4.2{\pm}1.2$, Focal: $6.5{\pm}4.7\;vs.\;3.5{\pm}1.3$). large adenomas (>1 cm) can be detected more in the focal uptake pattern (4 out of 5) rather than in segmental (1 out of 7) or diffuse uptake (none) and had higher SUV ($6.3{\pm}4.8$) than small adenomas ($3.5{\pm}3.0$) (statistically insignificant). Conclusion: focal FDG uptake is associated more often with large adenoma and other pathologic findings in colonoscopy. Segmental uptake cannot discriminate presence of adenoma from negative results, while diffuse pattern may have more chance to be normal.
Keywords
F-18-FDG PET; Colonic adenoma; Colonoscopy; Cancer screening;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Chun H, Kim CK, Krynckyi BR, Machac J. The usefulness of a repeat study for differentiating between bowel activity and local tumor recurrence on FDG PET scans. Clin Nucl Med 2003;28:672-673   DOI   ScienceOn
2 Kim S, Chung JK, Kim BT, Kim SJ, Jeong JM, Lee DS, Lee MC. Relationship between Gastrointestinal F-18-fluorodeoxyglucose Accumulation and Gastrointestinal Symptoms in Whole-Body PET. Clin Positron Imaging 1999;2:273-9   DOI   ScienceOn
3 Chen YK, Kao CH, Liao AC, Shen YY, Su CT. Colorectal cancer screening in asymptomatic adults: the role of FDG PET scan. Anticancer Res 2003;23:4357-61   PUBMED
4 Tatlidil R, Jadvar H, Bading JR, Conti PS. Incidental colonic fluorodeoxyglucose uptake: correlation with colonoscopic and histopathologic findings. Radiology 2002;224:783-7   DOI   ScienceOn
5 O'Brien MJ, Gibbons D. The adenoma-carcinoma sequence in colorectal neoplasia. Surg Oncol Clin N Am 1996;5:513-30   PUBMED
6 Okuno T, Fu KI, Sano Y, Yoshino T, Murakami K, Ochiai A, et al. Early colon cancers detected by FDG-pet: a report of two cases with immunohistochemical investigation. Hepatogastroenterology 2004;51:1323-5   PUBMED
7 Yang CM, Hsu CH, Lee CM, Wang FC. Intense uptake of [F-18]-fluoro-2 deoxy-D-glucose in active pulmonary tuberculosis. Ann Nucl Med. 2003;17:407-10   DOI   ScienceOn
8 Cook GJ, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of 18-fluoro-2-deoxyglucose positronemission tomography scanning: potential for error in interpretation. Semin Nucl Med 1996;26:308-14   DOI   ScienceOn
9 Zhuang H, Yu JQ , Alavi A. Applications of fluorodeoxyglucose-PET imaging in the detection of infection and inflammation and other benign disorders. Radiol Clin North Am 2005;43:121-34   DOI   ScienceOn
10 Shin SJ, Choi JW, Lee SK, Choi, CH, Kim TI, Kim WH. A case of multiple colonic adenomas which were found incidentally in FDG-PET. Korean Journal of Internal Medicine 2004;66:639-43
11 Yasuda S, Fujii H, Nakahara T, Nishiumi N, Takahashi W, Ide M, et al. 18F-FDG PET detection of colonic adenomas. J Nucl Med 2001;42:989-92   PUBMED
12 Hara AK, Johnson CD, Reed JE. Colorectal lesions: evaluation with CT colography. Radiographics 1997;17:1157-67   DOI   PUBMED
13 Gambhir SS, Czernin J, Schwimmer J, Silverman DH, Coleman RE, Phelps ME. A tabulated summary of the FDG PET literature. J Nucl Med 2001;42:1S-93S   PUBMED
14 Patrikeos AP, Mackay JR, Hicks RJ. Detection of synchronous adenocarcinomas and multiple dysplastic polyps with F-18 FDG positron emission tomography in a case of nonfamilial polyposis. Clin Nucl Med 2003;28:487-488   DOI   ScienceOn
15 한국중앙암등록본부. 보건복지부. 2002 Annual Report of the Korea Central Cancer Registry. 2003
16 Ransohoff DF, Johnson CD. Clinical practice. Screening for colorectal cancer. N Engl J Med 2002;346:40-4   DOI   ScienceOn
17 Meyer M. Diffusely increased colonic F-18 FDG uptake in acute enterocolitis. Clin Nucl Med 1995;20:434-5   DOI   PUBMED   ScienceOn
18 Kayani I, Groves AM, Syed R, Bomanji J. Combined F-18 FDG Positron Emission Tomography/Computed Tomography in the Diagnosis of Colonic Polyps: The Potential and Limitations of the Technique. Clin Nucl Med 2005;30:116-7   DOI   ScienceOn
19 Hannah A, Scott AM, Akhurst T, Berlangieri S, Bishop J, McKay WJ. Abnormal colonic accumulation of fluorine-18-FDG in pseudomembranous colitis. J Nucl Med 1996;37:1683-5
20 Drenth JP, Nagengast FM, Oyen WJ. Evaluation of (pre-)malignant colonic abnormalities: endoscopic validation of FDG-PET findings. Eur J Nucl Med 2001;28:1766-9   DOI   ScienceOn
21 Rex DK, Johnson DA, Lieberman DA, Burt RW, Sonnenberg A. Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology. Am J Gastroenterol 2000;95:868-77   PUBMED
22 Delbeke D, Martin WH. PET and PET-CT for evaluation of colorectal carcinoma. Semin Nucl Med 2004;34:209-23   DOI   ScienceOn