Clinical-endoscopic relevance of incidental colorectal lesions detected by PET-CT

Carmen Garrido Durán, María Antonia Payeras Capó, Carmen García Caparrós, Marta Giménez García, Jaime Daumal Domenech
2018 Revista Espanola de Enfermedades Digestivas  
Aim: to determine the proportion of incidental colon lesions detected by PET-CT and their correlation with the endoscopic and histological findings. In addition, to determine the maximum standardized uptake value (SUV max ) that can discriminate between benign and malignant lesions in our series of cases. Methods: this was a retrospective study of 3,000 patients evaluated by PET-CT for staging or response to treatment of primary neoplasms, between 2011 and 2015. Patients with incidental uptake
more » ... incidental uptake in the colon were included in the study. Exclusion criteria included an incomplete, poorly prepared or abandoned colonoscopy, inflammatory bowel disease and treatment with metformin. Results: the study cohort comprised 71 patients evaluated by PET-CT and subsequently analyzed by endoscopy; 69% were male with a mean age of 65.77 ± 11.2. The rate of incidental colon lesions found by PET-CT was 1.73%, with 52 incidental colonic uptakes reported in 50 patients. The location of the uptake was the rectum (19.23%), sigmoid colon (34.62%), descending colon (13.46%), transverse colon (1.9%), ascending colon (19.23%), cecum (9.62%) and ileocolic anastomosis (1.92%). Thirty-five pathological colonoscopies (71.15%) were identified: the findings included five neoplasms (13.51%), two inflammatory lesions (5.4%) and 30 adenomatous polyps (81.1%). Significant differences were found between neoplastic SUV max (11.7 g/ml; p = 0.03) and polyps (9.26 g/ml; p = 0.04) in relation to inflammatory lesions and normal endoscopies (6.05 g/ml). There were no differences in terms of the size of the polyps, nor the presence or absence of high grade dysplasia (p = 0.12 and 0.33). Both PET-CT and endoscopy proved consistent for locating lesions (k 0.90; CI 95% 0.86-0.93). Conclusion: there is a good correlation between the findings identified by PET-CT and the endoscopic study. In our study, a SUV max > 11 g/ml suggests a malignant pathology, which aids the prioritization of an endoscopic study.
doi:10.17235/reed.2018.4719/2016 pmid:29976073 fatcat:2c2s6kbxcng2na3smbn5etvnzi