Is It Useful to Perform Additional Colonoscopy to Detect Unmatched Lesion between Positron Emission Tomography/Computed Tomography and Colonoscopy?.
10.4166/kjg.2013.61.6.319
- Author:
Chang Yong YUN
1
;
Jun Oh JUNG
;
Seong O SUH
;
Ji Won YOO
;
Yu Mi OH
;
Soo Min AHN
;
Hyoung Hun SIM
;
Eun Sil KIM
;
Ji Yoon BAE
Author Information
1. Department of Internal Medicine, National Police Hospital, Seoul, Korea. jungjuno@nate.com
- Publication Type:Original Article ; English Abstract
- Keywords:
Positron-emission tomography and computed tomography;
Colonic neoplasms;
Colonoscopy
- MeSH:
Adenocarcinoma/pathology/radiography/radionuclide imaging;
Adenoma/pathology/radiography/radionuclide imaging;
Adult;
Aged;
Colonic Neoplasms/pathology/*radiography/*radionuclide imaging;
Colonic Polyps/pathology;
Colonoscopy;
Female;
Fluorodeoxyglucose F18/diagnostic use;
Humans;
Male;
Middle Aged;
Multimodal Imaging;
Positron-Emission Tomography;
Radiopharmaceuticals/diagnostic use;
Retrospective Studies;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2013;61(6):319-326
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Incidentally detected focal 18F-fluorodeoxyglucose (FDG) uptake was compared with colonoscopy. We investigated the characteristics of colon adenomas which were revealed on PET/CT. Then we identified whether additional colonoscopy was necessary in patients with lesions which were revealed on PET/CT but had no matched lesions on colonoscopy. METHODS: We retrospectively reviewed 95 patients who underwent colonoscopy within a 6 month interval after they had focal FDG uptake from January 2010 to May 2012 at National Police Hospital in Korea. Also, we analyzed 30 patients who underwent additional colonoscopy within 2 years after they had no matched lesions on primary colonoscopy. RESULTS: PET/CT depicted 54.6% (41/75) of adenomas and adenocarcinomas. The PET visibility of colon adenoma was significantly associated with degree of dysplasia (p=0.027), histologic type (p=0.040), and the size (p=0.038). The positivity rate was increased with higher degree of dysplasia (low-grade dysplasia, 47%; high-grade dysplasia, 78%; adenocarcinoma, 100%) and villous patterns of histologic type (tubular, 46.8%; tubulovillous, 87.5%; villous, 100%). Patients with adenomas larger than 10 mm (87.5%) had higher detection rate compared to those with adenomas smaller than 10 mm (49.0%). Among the 30 patients who underwent additional colonoscopy, only one patient had a 6 mm sized tubular adenoma (low-grade dysplasia). CONCLUSIONS: Incidental focal colonic uptake may indicate advanced adenoma or adenocarcinoma. Thus, it justifies performing colonoscopy for identifying the presence of colon neoplasms. However, in case of unmatched lesions between PET/CT and colonoscopy, there was little evidence that additional colonoscopy would yield benefits.
