Document Detail


Ability of integrated positron emission and computed tomography to detect significant colonic pathology: the experience of a tertiary cancer center.
MedLine Citation:
PMID:  20143447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The ability of integrated positron emission tomography and computed axial tomography (PET-CT) to detect colonic pathology is not fully defined. The purpose of this study was to assess the ability of PET-CT to detect colonic pathology and to determine the significance of ((18)F)2-fluoro-2-deoxyglucose ((18)F-FDG) activity noted incidentally in the colon on PET-CT. METHODS: Records for all patients who underwent PET-CT and colonoscopy at our institution were reviewed. Patients with history of colonic malignancy or colon surgery were excluded. RESULTS: Fifty-eight patients had incidental colonic (18)F-FDG activity on PET (Group A) and 272 had none (Group B). In Group A, 65% of patients had pathologic findings detected on colonoscopy that corresponded to the site of PET activity. Standardized uptake value (SUV) readings were not helpful in distinguishing true-positives from false-positives. In Group B, 11.8% of patients were found to have significant colonic findings. Lesions not detected by PET-CT included 4 colon cancers, 7 advanced adenomas, and 10 patients with colonic lymphoma. Overall, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET-CT for detecting significant pathology were 53%, 93%, 65%, 89%, and 85%, respectively. For detecting colon cancer and adenomas 10 mm or more, the sensitivity, specificity, PPV, NPV, and accuracy of PET-CT were 72%, 90%, 45%, 96%, and 88%, respectively. CONCLUSIONS: Incidental colonic activity detected by PET-CT warrants further evaluation with colonoscopy. However, negative PET-CT does not rule out significant colonic pathology including colon cancer, advanced adenomas, or lymphoma.
Authors:
Brian R Weston; Revathy B Iyer; Wei Qiao; Jeffrey H Lee; Robert S Bresalier; William A Ross
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Cancer     Volume:  116     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-10     Completed Date:  2010-04-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1454-61     Citation Subset:  AIM; IM    
Affiliation:
Department of Gastroenterology, Hepatology and Nutrition, Unit 1466, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-1402, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / diagnosis
Colon / radiography*,  radionuclide imaging*
Colonic Neoplasms / diagnosis*
Colonoscopy
Deoxyglucose / diagnostic use
False Positive Reactions
Female
Humans
Incidental Findings
Lymphoma / diagnosis
Male
Middle Aged
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use
Sensitivity and Specificity
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 154-17-6/Deoxyglucose

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