PDF(Pubmed)
Abstract：
BACKGROUND: Incidental colorectal fluorodeoxyglucose (FDG) uptake, observed during positron emission tomography/computed tomography (PET/CT) scans, attracts particular attention due to its potential to represent both benign and pre-malignant/malignant lesions. Early detection and excision of these lesions are crucial for preventing cancer development and reducing mortality. This research aims to evaluate the correlation between incidental colorectal FDG uptake on PET/CT with colonoscopic and histopathological results.
METHODS: Retrospective analysis was performed on data from all patients who underwent PET/CT between December 2019 and December 2023 in our hospital. The study included 79 patients with incidental colonic FDG uptake who underwent endoscopy. Patient characteristics, imaging parameters, and the corresponding colonoscopy and histopathological results were studied. A comparative analysis was performed among the findings from each of these modalities. The optimal cut-off value of SUVmax for 18F-FDG PET/CT diagnosis of premalignant and malignant lesions was determined by receiver operating characteristic (ROC) curves. The area under the curve (AUC) of SUVmax and the combined parameters of SUVmax and colonic wall thickening (CWT) were analyzed.
RESULTS: Among the 79 patients with incidental colorectal FDG uptake, histopathology revealed malignancy in 22 (27.9%) patients and premalignant polyps in 22 (27.9%) patients. Compared to patients with benign lesions, patients with premalignant and malignant lesions were more likely to undergo a PET/CT scan for primary evaluation (p = 0.013), and more likely to have focal GIT uptake (p = 0.001) and CWT (p = 0.001). A ROC curve analysis was made and assesed a cut-off value of 7.66 SUVmax (sensitivity: 64.9% and specificity: 82.4%) to distinguish premalignant and malignant lesions from benign lesions. The AUCs of the SUVmax and the combined parameters of SUVmax and CWT were 0.758 and 0.832 respectively.
CONCLUSIONS: For patients undergo PET/CT for primary evaluation, imaging features of colorectal focal FDG uptake and CWT were more closely associated with premalignant and malignant lesions. The SUVmax helps determine benign and premalignant/malignant lesions of the colorectum. Moreover, the combination of SUVmax and CWT parameters have higher accuracy in estimating premalignant and malignant lesions than SUVmax.
METHODS: Retrospective analysis was performed on data from all patients who underwent PET/CT between December 2019 and December 2023 in our hospital. The study included 79 patients with incidental colonic FDG uptake who underwent endoscopy. Patient characteristics, imaging parameters, and the corresponding colonoscopy and histopathological results were studied. A comparative analysis was performed among the findings from each of these modalities. The optimal cut-off value of SUVmax for 18F-FDG PET/CT diagnosis of premalignant and malignant lesions was determined by receiver operating characteristic (ROC) curves. The area under the curve (AUC) of SUVmax and the combined parameters of SUVmax and colonic wall thickening (CWT) were analyzed.
RESULTS: Among the 79 patients with incidental colorectal FDG uptake, histopathology revealed malignancy in 22 (27.9%) patients and premalignant polyps in 22 (27.9%) patients. Compared to patients with benign lesions, patients with premalignant and malignant lesions were more likely to undergo a PET/CT scan for primary evaluation (p = 0.013), and more likely to have focal GIT uptake (p = 0.001) and CWT (p = 0.001). A ROC curve analysis was made and assesed a cut-off value of 7.66 SUVmax (sensitivity: 64.9% and specificity: 82.4%) to distinguish premalignant and malignant lesions from benign lesions. The AUCs of the SUVmax and the combined parameters of SUVmax and CWT were 0.758 and 0.832 respectively.
CONCLUSIONS: For patients undergo PET/CT for primary evaluation, imaging features of colorectal focal FDG uptake and CWT were more closely associated with premalignant and malignant lesions. The SUVmax helps determine benign and premalignant/malignant lesions of the colorectum. Moreover, the combination of SUVmax and CWT parameters have higher accuracy in estimating premalignant and malignant lesions than SUVmax.
摘要：
背景：偶然的结肠直肠氟脱氧葡萄糖（FDG）摄取，在正电子发射断层扫描/计算机断层扫描（PET/CT）扫描中观察到，由于其代表良性和恶性前/恶性病变的潜力而引起特别关注。早期发现和切除这些病变对于预防癌症发展和降低死亡率至关重要。这项研究旨在评估PET/CT上偶然的结直肠FDG摄取与结肠镜和组织病理学结果之间的相关性。
方法：回顾性分析2019年12月至2023年12月在我院接受PET/CT检查的所有患者的资料。该研究包括79例接受内窥镜检查的偶然结肠FDG摄取患者。患者特征,成像参数,并对相应的结肠镜检查和组织病理学结果进行了研究。对每种模式的结果进行了比较分析。通过受试者工作特征（ROC）曲线确定18F-FDGPET/CT诊断癌前和恶性病变的最佳SUVmax临界值。分析SUVmax的曲线下面积（AUC）以及SUVmax和结肠壁增厚（CWT）的联合参数。
结果：在79例结直肠FDG偶然摄取的患者中，组织病理学显示22例（27.9％）患者为恶性肿瘤，22例（27.9％）患者为癌前息肉。与良性病变患者相比，癌前病变和恶性病变患者更有可能接受PET/CT扫描以进行初步评估（p=0.013），并且更可能具有局灶性GIT摄取（p=0.001）和CWT（p=0.001）。进行ROC曲线分析，并评估了7.66SUVmax的临界值（敏感性：64.9％，特异性：82.4％），以区分癌前和恶性病变与良性病变。SUVmax的AUC以及SUVmax和CWT的组合参数分别为0.758和0.832。
结论：对于接受PET/CT初步评估的患者，结直肠局灶性FDG摄取和CWT的影像学特征与癌前病变和恶性病变更密切相关。SUVmax有助于确定结肠直肠的良性和癌前/恶性病变。此外，与SUVmax相比,SUVmax和CWT参数的组合在评估癌前病变和恶性病变方面具有更高的准确性.
方法：回顾性分析2019年12月至2023年12月在我院接受PET/CT检查的所有患者的资料。该研究包括79例接受内窥镜检查的偶然结肠FDG摄取患者。患者特征,成像参数,并对相应的结肠镜检查和组织病理学结果进行了研究。对每种模式的结果进行了比较分析。通过受试者工作特征（ROC）曲线确定18F-FDGPET/CT诊断癌前和恶性病变的最佳SUVmax临界值。分析SUVmax的曲线下面积（AUC）以及SUVmax和结肠壁增厚（CWT）的联合参数。
结果：在79例结直肠FDG偶然摄取的患者中，组织病理学显示22例（27.9％）患者为恶性肿瘤，22例（27.9％）患者为癌前息肉。与良性病变患者相比，癌前病变和恶性病变患者更有可能接受PET/CT扫描以进行初步评估（p=0.013），并且更可能具有局灶性GIT摄取（p=0.001）和CWT（p=0.001）。进行ROC曲线分析，并评估了7.66SUVmax的临界值（敏感性：64.9％，特异性：82.4％），以区分癌前和恶性病变与良性病变。SUVmax的AUC以及SUVmax和CWT的组合参数分别为0.758和0.832。
结论：对于接受PET/CT初步评估的患者，结直肠局灶性FDG摄取和CWT的影像学特征与癌前病变和恶性病变更密切相关。SUVmax有助于确定结肠直肠的良性和癌前/恶性病变。此外，与SUVmax相比,SUVmax和CWT参数的组合在评估癌前病变和恶性病变方面具有更高的准确性.
