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Role of Positron Emission Tomography in Assessing Disease Activity in Ulcerative Colitis: Comparison with Biomarkers

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Abstract

Background

Disease activity in ulcerative colitis (UC) is best assessed clinically by Mayo score. 18-Fluorodeoxyglucose positron emission tomography-computerized tomography (FDG PET-CT) is a noninvasive imaging technique to assess extent, disease activity and response to treatment of UC, especially in high risk population or patients unwilling for endoscopy.

Aims

We conducted a prospective observational study with the aim of assessing and correlating UC disease activity by clinical criteria, endoscopy, histology, serum and fecal biomarkers, and FDG PET-CT.

Methods

Sixty eligible patients of UC were enrolled into three groups (26 remission, 24 moderate and 10 severe activity) as per Mayo score and FDG PET-CT was performed within 72 h of colonoscopy. ESR, CRP, and fecal calprotectin (FC) levels were determined for all patients.

Results

Of 60 enrolled patients, 10% patients had proctitis, 43.3% left-sided colitis, and 46.7% extensive colitis. ESR, CRP, FC levels, and rectal PET activity were significantly higher in groups with moderate and severe disease activity. Rectal PET activity showed a significant correlation with the Mayo score (k = 0.465, p < 0.001), endoscopic subscore (k = 0.526, p < 0.001), histological score (k = 0.496, p < 0.001), and FC (k = 0.279, p = 0.031). Extent evaluation by FDG PET-CT and colonoscopy showed a significant correlation (k = 0.582, p < 0.001). Besides, FDG PET-CT identified sacroiliitis in one patient and adenocarcinoma in one patient.

Conclusion

FDG PET-CT is a reliable noninvasive tool for detection of disease activity, extent in UC with good correlation with Mayo score, histology and fecal biomarkers and accurate predictor of disease remission.

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Abbreviations

UC:

Ulcerative colitis

IBD:

Inflammatory bowel disease

CD:

Crohn’s disease

CDTA:

Clostridium difficile toxin assay

FC:

Fecal calprotectin

18-FDG PET:

Positron emission tomography with 18-fluorodeoxyglucose

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Authors and Affiliations

  1. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India

    Neha Berry, Saroj Kant Sinha, K. K. Prasad, Chetana Vaishnavi, Jayanta Samanta, Raghavendra Prasada, Narendra Dhaka & Rakesh Kochhar

  2. Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Anish Bhattacharya

  3. Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Kim Vaiphei

Authors
  1. Neha Berry
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  2. Saroj Kant Sinha
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  3. Anish Bhattacharya
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  4. K. K. Prasad
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  5. Chetana Vaishnavi
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  6. Kim Vaiphei
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  7. Jayanta Samanta
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  8. Raghavendra Prasada
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  9. Narendra Dhaka
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  10. Rakesh Kochhar
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Contributions

NB helped in literature search, figures, study design, data collection, data analysis, data interpretation, and writing. SKS involved in study design, data analysis, and data interpretation. AB helped in study design, data collection, data analysis, and PET-CT scans. KKP involved in histopathological analysis. CV helped in biochemical tests, stool tests, data collection, and data analysis. KV helped in histopathological analysis. JS involved in data collection, data analysis, and data interpretation. RP involved in data collection. ND helped in data interpretation. RK involved in study design, data analysis, and data interpretation.

Corresponding author

Correspondence to Saroj Kant Sinha.

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The authors declare that they have no conflict of interest.

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Berry, N., Sinha, S.K., Bhattacharya, A. et al. Role of Positron Emission Tomography in Assessing Disease Activity in Ulcerative Colitis: Comparison with Biomarkers. Dig Dis Sci 63, 1541–1550 (2018). https://doi.org/10.1007/s10620-018-5026-3

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  • DOI: https://doi.org/10.1007/s10620-018-5026-3

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