Endoscopic and histopathological analysis of incidental focal colorectal 18 F-fluorodeoxyglucose uptake in PET/CT scan: Colonoscopic evaluation is warranted

Am J Surg. 2018 Mar;215(3):379-381. doi: 10.1016/j.amjsurg.2017.11.010. Epub 2017 Nov 11.

Abstract

Background: Unexpected focal colorectal 18 F-fluorodeoxyglucose uptake has become a common clinical dilemma. The aim of this study was to identify the clinical significance of incidentally detected colorectal lesions on PET/CT scans by comparing positive PET/CT findings with endoscopic and histopathological analysis.

Methods: A retrospective analysis of a colonoscopy database was reviewed. All patients that underwent colonoscopy secondary to focal incidental uptake on PET/CT were evaluated. PET/CT findings were correlated with endoscopic and histopathological results.

Results: 84 patients underwent colonoscopy secondary to incidental focal colorectal uptake on PET/CT. A total of 63 patients had an endoscopic and histological confirmation of the area of abnormality, for a positive predictive value of 75%. Newly diagnosed colorectal carcinoma was discovered in 13 patients (15.4%) and forty-four patients (52.3%) were discovered to have a premalignant lesion.

Conclusion: Incidental focal colorectal uptake of 18 F-fluorodeoxyglucose is associated with a substantial risk of underlying neoplastic colorectal lesions. Early identification of these lesions may alter patient management and treatment plans.

Keywords: (18) F-fluorodeoxyglucose; Colonoscopy; Incidental colorectal lesions; PET/CT scan.

MeSH terms

  • Adenoma / diagnostic imaging
  • Adenoma / pathology
  • Aged
  • Aged, 80 and over
  • Carcinoma / diagnostic imaging
  • Carcinoma / pathology
  • Colonoscopy*
  • Colorectal Neoplasms / diagnostic imaging*
  • Colorectal Neoplasms / pathology
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Incidental Findings*
  • Male
  • Melanoma / diagnostic imaging
  • Melanoma / pathology
  • Middle Aged
  • Positron Emission Tomography Computed Tomography*
  • Precancerous Conditions / diagnostic imaging
  • Precancerous Conditions / pathology
  • Radiopharmaceuticals*
  • Retrospective Studies

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18