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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(12): E1725-E1731
DOI: 10.1055/a-1266-3308
Original article

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

Sabrina Just Kousgaard
1   Department of Gastrointestinal Surgery and Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
3   Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
,
Michael Gade
2   Department of Nuclear Medicine, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
,
Lars Jelstrup Petersen
2   Department of Nuclear Medicine, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
3   Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
,
Ole Thorlacius-Ussing
1   Department of Gastrointestinal Surgery and Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
3   Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Abstract

Background and study aims Further diagnostics of incidental colorectal lesions on 18F-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.



Publication History

Received: 28 February 2020

Accepted: 18 August 2020

Article published online:
17 November 2020

© 2020. 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/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2021; 53(01): 106-106
DOI: 10.1055/a-1273-0157

 

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