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Sensitivity of 2-[18F]fluoro-2-deoxyglucose positron emission tomography for advanced colorectal neoplasms: a large-scale analysis of 7505 asymptomatic screening individuals

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Abstract

Background

The sensitivity of 2-[18F]fluoro-2-deoxyglucose positron emission tomography (FDG-PET) for advanced colorectal neoplasms among healthy subjects is not yet fully understood. The present study aimed to clarify the sensitivity by analyzing large-scale data from an asymptomatic screening population.

Methods

A total of 7505 asymptomatic screenees who underwent both FDG-PET and colonoscopy at our Cancer Screening Division between February 2004 and March 2013 were analyzed. FDG-PET and colonoscopy were performed on consecutive days, and each examination was interpreted in a blinded fashion. The results of the two examinations were compared for each of the divided six colonic segments, with those from colonoscopy being set as the reference. The relationships between the sensitivity of FDG-PET and clinicopathological features of advanced neoplasms were also evaluated.

Results

Two hundred ninety-one advanced neoplasms, including 24 invasive cancers, were detected in 262 individuals. Thirteen advanced neoplasms (advanced adenomas) were excluded from the analysis because of the coexistence of lesions in the same colonic segment. The sensitivity, specificity, and positive and negative predictive values of FDG-PET for advanced neoplasms were 16.9 % [95 % confidence interval (CI) 12.7–21.8 %], 99.3 % (95 % CI 99.2–99.4 %), 13.5 % (95 % CI 10.1–17.6 %), and 99.4 % (95 % CI 99.3–99.5 %), respectively. The sensitivity was lower for lesions with less advanced histological grade, of smaller size, and flat-type morphology, and for those located in the proximal part of the colon.

Conclusions

FDG-PET is believed to be difficult to use as a primary screening tool in population-based colorectal cancer screening because of its low sensitivity for advanced neoplasms. Even when it is used in opportunistic cancer screening, the limit of its sensitivity should be considered.

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Acknowledgment

This study was supported in part by the National Cancer Center Research and Development Fund (27-A-5).

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Authors and Affiliations

  1. Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Masau Sekiguchi, Yasuo Kakugawa, Minori Matsumoto, Yutaka Saito & Takahisa Matsuda

  2. Cancer Screening Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan

    Takashi Terauchi, Yukio Muramatsu & Takahisa Matsuda

  3. Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan

    Hiroshi Saito

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  1. Masau Sekiguchi
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  2. Yasuo Kakugawa
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Correspondence to Masau Sekiguchi.

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Sekiguchi, M., Kakugawa, Y., Terauchi, T. et al. Sensitivity of 2-[18F]fluoro-2-deoxyglucose positron emission tomography for advanced colorectal neoplasms: a large-scale analysis of 7505 asymptomatic screening individuals. J Gastroenterol 51, 1122–1132 (2016). https://doi.org/10.1007/s00535-016-1201-5

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  • DOI: https://doi.org/10.1007/s00535-016-1201-5

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