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Clinical Utility of Positron Emission Tomography/Computed Tomography in Inflammatory Bowel Disease

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Abstract

Purpose

The clinical utility of positron emission tomography/computed tomography (PET/CT) in comparison to standard workup in patients with known or suspected inflammatory bowel disease (IBD) is unknown.

Procedures

Clinical data were collected on seven patients with known or suspected IBD undergoing PET/CT. Standard workup included history, physical exam, laboratory tests, colonoscopy and/or cross-sectional imaging. We divided the intestine into five regions [small bowel and four colon (ascending, transverse, descending and rectosigmoid)] and graded relative standard uptake values 0, 1, 2 or 3 by comparison to the liver, using a region-of-interest analysis (0 = no activity, 1 = liver, 2 and 3 = significant inflammation).

Results

In patients 1 and 2, PET/CT demonstrated more activity than we thought clinically present. The other patients avoided unnecessary escalation or initiation of IBD therapy based on PET/CT results. Compared with standard workup, all seven patients had superior results when therapeutic decisions were based on PET/CT.

Conclusions

We found PET/CT to be very useful in diagnosis and management in patients with known or suspected IBD.

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References

  1. 1.

    Xavier RJ, Podolsky DK (2007) Unraveling the pathogenesis of inflammatory bowel disease. Nature 448:427–434

  2. 2.

    Abraham C, Cho J (2009) Inflammatory bowel disease. N Engl J Med 361:2066–2078

  3. 3.

    Bernstein CN, Fried M, Krabshuis JH et al (2010) World gastroenterology organization practice guidelines for the diagnosis and management of IBD in 2010. Inflamm Bowel Dis 16:112–124

  4. 4.

    Spier BJ, Perlman SB, Reichelderfer MX (2009) FDG-PET in inflammatory bowel disease. QJ Nucl Med Mol Imaging 53:64–71

  5. 5.

    Bick I, Bauerfeind P, BreitBach T et al (1997) Inflammatory bowel disease activity measured by positron-emission tomography. Lancet 350:262

  6. 6.

    Lemberg DA, Issenman RM, Cawdron R et al (2005) Positron emission tomography in the investigation of pediatric inflammatory bowel disease. Inflamm Bowel Dis 11:733–738

  7. 7.

    Loffler M, Weckesser M, Franzius C et al (2006) High diagnostic value of 18F-FDG-PET in pediatric patients with chronic inflammatory bowel disease. Ann N Y Acad Sci 1072:379–385

  8. 8.

    Neurath MF, Vehling D, Schunk K et al (2002) Noninvasive assessment of Crohn's disease activity: a comparison of 18F-fluorodeoxyglucose positron emission tomography, hydromagnetic resonance imaging, and granulocyte scintigraphy with labeled antibodies. Am J Gastroenterol 97:1978–1985

  9. 9.

    Adler J, Stidham RW, Higgins PDR (2009) Bringing the inflamed and fibrotic bowel into focus: imaging in inflammatory bowel disease. Gastroenterology & Hepatology 5:705–715

  10. 10.

    Louis E, G. Ancion A, Colard V et al (2007) Noninvasive assessment of Crohn's disease intestinal lesions with (18)F-FDG PET/CT. J Nucl Med 48:1053–1059,

  11. 11.

    Meisner, Randall S, Bret J Spier, Sigurdur Einarsson et al (2007) Pilot study using PET/CT as a novel, noninvasive assessment of disease activity in inflammatory bowel disease. Inflammatory Bowel Disease 13:993–1000

  12. 12.

    Spier BJ, Perlman SB, Jaskowiak CJ et al (2009) PET/CT in the evaluation of inflammatory bowel disease: studies in patients before and after treatment. Molecular Imaging and Biology

  13. 13.

    Harvey RF, Bradshaw JM (1980) A simple index of Crohn's-disease activity. Lancet 1:514

  14. 14.

    Sandborn WJ, Tremaine WJ, Batts KP et al (1994) Pouchitis after ileal pouch-anal anastomosis: a pouchitis disease activity index. Mayo Clin Proc 69:409–415

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Acknowledgements

This study was funded in part by an unrestricted grant from Proctor & Gamble Pharmaceuticals.

Disclosure

None of the authors have conflicts to disclose.

Author information

Correspondence to Mark Reichelderfer.

Additional information

This is an article describing the clinical utility of PET/CT compared to standard workup in patients with known or suspected IBD. This manuscript is important as it evaluates the use of PET/CT to guide clinical management in patients with known or suspected IBD.

Financial Disclosures: This study was funded in part by an unrestricted grant from Proctor & Gamble Pharmaceuticals.

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Lapp, R.T., Spier, B.J., Perlman, S.B. et al. Clinical Utility of Positron Emission Tomography/Computed Tomography in Inflammatory Bowel Disease. Mol Imaging Biol 13, 573–576 (2011). https://doi.org/10.1007/s11307-010-0367-0

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Key words

  • Inflammatory Bowel Disease
  • Pet/CT
  • Clinical
  • Crohn's colitis
  • Ulcerative Colitis