Using ~(18)F-FDG positron emission tomography/computed tomography to judge benign or malignant colorectal hypermetabolic lesions
- VernacularTitle:~(18)F-FDG PET/CT结直肠代谢活跃灶分型对于良恶性判断的价值
- Author:
Li WEI
1
,
2
,
3
;
Fan WEI
Author Information
1. 华南肿瘤学国家重点实验室,广东,广州,510060
2. 中山大学肿瘤防治中心核医学科,广东,广州,510060
3. 广州医学院附属肿瘤医院放射科,广东、广州,510095
- Keywords:
Colorectal neoplasm;
fluorodeoxyglucose;
PET/CT;
diagnosticimaging
- From:Chinese Journal of Cancer
2010;29(3):330-336
- CountryChina
- Language:Chinese
-
Abstract:
Background and Objective:The colorectum is long and its position is not fixed.The thickness of the colorectal wall is unfixed because it changes following wall contractions.The metabolism of the colorectum is not stable and abnormal metabolism results from smooth muscle movement,gland action,spasm,inflamnlation,and so on.These anatomic and physiologic factors can bring a few difficulties in correctly judging colorectal information on ~(18)F-FDG positron emission tomography/computed tomography (PET/CT)scans.This study was to discuss the imaging characterstics of colorectal hypermetabolic lesions in ~(18)F-FDG PET/CT and their values to clinical diagnosis.Methods:According the metabolic characteristics and the shape of the lesion,118 colorectal hypermetabolic lesions of 74 patients were detected by ~(18)F-FDG PET/CT and separated to 6 groups(localized/CT~+ ,localized/CT~-,segmented/CT~+,segmented/CT~-,diffuse/CT~+,diffuse/CT~-).To contrast groups and the qualitative data,a R×C X~2 test was performed to iudge statistical differences.Results:ln the 118 lesions,50 were determined to be malignant and 68 nonmalignant.A total of 30 lesions were in the localized/CT~+ group(23 malignant,7 non),35 to the localized/CT~- group(22 malignant,13 non),4 to the segmented/CT~+ group(4 malignant,0 non),35 to the segmented/CT~- group(1 malignant,34 non),0 to the diffuse/CT~+group,14 to the diffuse/CT~- group(0 malignant,14non).The rates of nonmalignant lesions in the segmented/CT~- and diffuse/CT~- groups(97.1%,100%)and of malignant lesions in the segmented/CT~+ groups(100%)were similar,so these three groups were combined to a nonlocalized group.The group of diffuse/CT~+ was deleted.There were significant differences among the three groups of nonlocalized,localized/CT~+,and localized/CT~- (P＜0.001).The localized/CT~+ and localized/CTgroups were combined into one localized group because no significant difference was found between them(P=0.229).There was a significant difference between the nonlocalized and the localized groups(P＜0.001).Conclusions:On ~(18)F-FDG PET/CT,colorectal hypermetabolic lesions in the diffuse/CT~- or segmented/CT~- groups were highly likely to be nonmalignant and those in the segmented/CT~+ group were highly likely to be malignant.Lesions in the localized/CT~+ or localized/CT~- groups had only a normal likelihood of being malignant.To correctly diagnose colorectal hypermetabolic lesions,it is necessary to analyze the PET of the metabolism and the CT of the anatomy together.Especially for the metabolic lesions of the localized/CT~- group,we cannot easily make the judgment of malignant or nonmalignant unless we refer to the relevant clinical data.
