Clinical Significance of Incidental Colonic 18F-FDG Uptake on PET/CT Images in Patients with Gastric Adenocarcinoma

• Published in: Journal of gastrointestinal surgery 2012-10, Vol.16 (10), p.1847-1853
• Main Authors: Shim, Jung Ho, O, Joo Hyun, Oh, Seong Il, Yoo, Han Mo, Jeon, Hae Myung, Park, Cho Hyun, Kim, Sung Hoon, Song, Kyo Young
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnostic imaging; Adenoma - diagnostic imaging; Adenoma - pathology; Adult; Aged; Aged, 80 and over; Colon - diagnostic imaging; Colon - metabolism; Colon - pathology; Colonic Neoplasms - diagnostic imaging; Colonic Neoplasms - pathology; Colonic Polyps - diagnostic imaging; Colonic Polyps - pathology; Colonoscopy; False Negative Reactions; False Positive Reactions; Female; Fluorodeoxyglucose F18 - pharmacokinetics; Gastroenterology; Humans; Incidental Findings; Male; Medicine; Medicine & Public Health; Middle Aged; Multimodal Imaging; Neoplasms, Multiple Primary - diagnostic imaging; Neoplasms, Multiple Primary - pathology; Original Article; Positron-Emission Tomography; Radiopharmaceuticals - pharmacokinetics; Retrospective Studies; Stomach Neoplasms - diagnostic imaging; Surgery; Tissue Distribution; Tomography, X-Ray Computed
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-012-1941-3

Background and Objectives We assessed the ability of positron emission tomography–computed tomography (PET/CT) to detect synchronous colonic pathology and determined the significance of 18F-fluorodeoxyglucose ( 18 F-FDG) activity in the colon of gastric cancer patients. Methods A total of 239 gastric cancer patients who underwent PET/CT and colonoscopy preoperatively were included. FDG uptake patterns on PET/CT were classified as (1) group A, focal; (2) group B, diffuse; and (3) group C, no uptake. The PET/CT findings were compared with the results of concurrent colonoscopy. Results In group A, a total of 123 polyps of >0 mm were observed. Of these, nine polyps were colonic adenocarcinomas and six were high-grade dysplasia. The incidence of colonic adenocarcinomas was significantly higher in group A than in the other two groups ( p  = 0.037). There was a significant correlation between SUVmax values and incidence of colonic polyps of >10 mm ( r  = 0.471, p  = 0.04). The distribution pattern of SUVmax in polyps with adenoma (>10 mm) was less homogenous than in polyps (>10 mm) with adenocarcinoma. Conclusions The focal colonic FDG uptake in PET/CT requires colonoscopic confirmation. The suspicion of colonic malignancy increased in the presence of polyps >10 mm that showed a positive correlation with the SUVmax.