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A novel objective method for discriminating pathological and physiological colorectal uptake in the lower abdominal region using whole-body dynamic 18F-FDG-PET

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Abstract

Objectives

To investigate whether the center-of-mass shift distance (CMSD) analysis on whole-body dynamic positron emission tomography (WBD-PET) with continuous bed motion is an objective index for discriminating pathological and physiological uptake in the lower abdominal colon.

Methods

We retrospectively analyzed the CMSD in 39 patients who underwent delayed imaging to detect incidental focal uptake that was difficult to determine as pathological and physiological on a conventional early-PET (early) image reconstructed by 5-phase WBD-PET images. The CMSD between each phase of WBD-PET images and between conventional early and delayed (two-phase) PET images were classified into pathological and physiological uptake groups based on endoscopic histology or other imaging diagnostics. The diagnostic performance of CMSD analysis on WBD-PET images was evaluated by receiver operator characteristic (ROC) analysis and compared to that of two-phase PET images.

Results

A total of 66 incidental focal uptake detected early image were classified into 19 and 47 pathological and physiological uptake groups, respectively. The CMSD on WBD-PET and two-phase PET images in the pathological uptake group was significantly lower than that in the physiological uptake group (p < 0.01), respectively. The sensitivity, specificity, and accuracy in CMSD analysis on WBD-PET images at the optimal cutoff of 5.2 mm estimated by the Youden index were 94.7%, 89.4%, and 89.4%, respectively, which were not significantly different (p = 0.74) from those of two-phase PET images.

Conclusions

The CMSD analysis on WBD-PET was useful in discriminating pathological and physiological colorectal uptake in the lower abdominal region, and its diagnostic performance was comparable to that of two-phase PET images. We suggested that CMSD analysis on WBD-PET images would be a novel objective method to omit unnecessary additional delayed imaging.

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Data availability

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

References

  1. Ronald B, Roberto DB, Wim JGO, Francesco G, Klaus T, Wolfgang E, et al. FDG-PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015;42:328–54.

    Article  Google Scholar 

  2. Devaki SS, Pradeep B, Jon AB, Samuel EA, Janis PO. 18F-FDG-PET and PET/CT patient preparation: a review of the literature. J Nucl Med Technol. 2014;421:5–13.

    Google Scholar 

  3. Koosha P, Siavash MS, Mahdi ZZ, Sahra E, Sara PS, Saeid G, et al. The evolving role of FDG-PET/CT in the diagnosis, staging, and treatment of breast cancer. Mol Imaging Biol. 2019;21:1–10.

    Article  Google Scholar 

  4. Fletcher JM, Djulbegovic B, Soares HP, SiegelBA LVJ, Lyman GH, et al. Recommendations on the use of 18F-FDG-PET in oncology. J Nucl Med. 2008;49:480–508.

    Article  PubMed  Google Scholar 

  5. Paul DS, Yoshimi A, Richard LW. Pitfalls in oncologic diagnosis with FDG-PET imaging: physiological and benign variants. Radiographics. 1999;19:61–77.

    Article  Google Scholar 

  6. Sarji SA. Physiological uptake in FDG-PET simulating disease. Biomed Imaging Interv J. 2006;2:e59.

    Google Scholar 

  7. Lan XL, Zhang YX, Wu ZJ, Jia Q, Wei H, Gao ZR. The value of dual-time-point (18)F-FDG-PET imaging for the differentiation between malignant and benign lesions. Clin Radiol. 2008;63:756–64.

    Article  PubMed  Google Scholar 

  8. Kubota K, Itoh M, Ozaki K, Ono S, Tashiro M, Yamaguchi K, et al. Advantage of delayed whole-body FDG-PET imaging for tumour detection. Eur J Nucl Med. 2001;28:696–702.

    Article  CAS  PubMed  Google Scholar 

  9. Miyake K, Nakamoto Y, Togashi K. Dual-time-point 18F-FDG-PET/CT in patients with colorectal cancer: clinical value of early–delayed scanning. Ann Nucl Med. 2012;26:492–500.

    Article  CAS  PubMed  Google Scholar 

  10. Minamimoto R, Terauchi T, Jinnouchi S, Yoshida T, Tsukamoto E, Shimbo T, et al. Observer variation study of the assessment and diagnosis of incidental colonic FDG uptake. Ann Nucl Med. 2013;27:468–77.

    Article  PubMed  Google Scholar 

  11. Ichikawa H, Kato T, Miwa K, Shibutani T, Okuda K, Nagaki A, et al. Current state of oncologic 18F-FDG PET/CT in Japan: a nationwide survey. Asia Ocean J Nucl Med Biol. 2021;9:158.

    PubMed  PubMed Central  Google Scholar 

  12. Kato T, Ichikawa H, Miwa K, Okuda K, Shibutani T, Nagaki A, et al. A nationwide survey on additional scan in nuclear medicine imaging. Jpn J Radiol Technol. 2020;76:285–94.

    Article  CAS  Google Scholar 

  13. Ushio A, Takauchi K, Kobayashi M, Abe N, Sumida H, Nagata Y, et al. Differentiation between hepatic focal lesions and heterogenous physiological accumulations by early–delayed scanning in 18F-FDG-PET/CT examination. Jpn J Radiol Technol. 2018;74:556–62.

    Article  CAS  Google Scholar 

  14. Rahmim A, Lodge MA, Karakatsanis NA, Panin VY, Zhou Y, McMillan A, et al. Dynamic whole-body PET imaging: principles, potentials and applications. Eur J Nucl Med Mol Imaging. 2019;46:501–18.

    Article  PubMed  Google Scholar 

  15. Osborne DR, Acuff S. Whole-body dynamic imaging with continuous bed motion PET/CT. Nucl Med Commun. 2016;37:428–31.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Nishimura M, Tamaki N, Matsushima S, Kiba M, Kotani T, Bamba C, et al. Dynamic whole-body 18F-FDG-PET for differentiating abnormal lesions from physiological uptake. Eur J Nucl Med Mol Imaging. 2020;47:2293–300.

    Article  CAS  PubMed  Google Scholar 

  17. Kotani T, Nishimura M, Tamaki N, Matsushima S, Akiyama S, Kanayama T, et al. Comparison between dynamic whole-body FDG-PET and early–delayed imaging for the assessment of motion in focal uptake in colorectal area. Ann Nucl Med. 2021;35:1305–11.

    Article  CAS  PubMed  Google Scholar 

  18. Lee C, Langen KM, Lu W, Haimerl J, Schnarr E, Ruchala KJ, et al. Evaluation of geometric changes of parotid glands during head and neck cancer radiotherapy using daily MVCT and automatic deformable registration. Radiother Oncol. 2008;89:81–8.

    Article  PubMed  Google Scholar 

  19. Tanabe Y, Kiritani M, Deguchi T, Hira N, Tomimoto S. Patient-specific respiratory motion management using lung tumors vs fiducial markers for real-time tumor-tracking stereotactic body radiotherapy. Phys Imaging Radiat Oncol. 2023;25:100405.

    Article  PubMed  Google Scholar 

  20. Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3:32–5.

    Article  CAS  PubMed  Google Scholar 

  21. Nakayama S. Colonic motility. J Jpn Soc Coloproctol. 1986;39:799–805.

    Article  Google Scholar 

  22. Keall PJ, Mageras GS, Balter JM, Emery RS, Forster KM, Jiang SB, et al. The management of respiratory motion in radiation oncology report of AAPM Task Group 76 a. Med Phys. 2006;33:3874–900.

    Article  PubMed  Google Scholar 

  23. Davies SC, Hill AL, Holmes RB, Halliwell M, Jackson PC. Ultrasound quantitation of respiratory organ motion in the upper abdomen. Brit J Radiol. 1994;67:1096–102.

    Article  CAS  PubMed  Google Scholar 

  24. Uehara T, Takeno M, Hama M, Yoshimi M, Suda R, Ihata A, et al. Deep-inspiration breath-hold 18F-FDG-PET/CT is useful for assessment of connective tissue disease associated interstitial pneumonia. Mod Rheumatol. 2016;26:121–7.

    Article  CAS  PubMed  Google Scholar 

  25. Nagamachia S, Wakamatsua H, Kiyohara S, Fujita S, Futami S, Arita H, et al. Usefulness of a deep-inspiration breath-hold 18F-FDG-PET/CT technique in diagnosing liver, bile duct, and pancreas tumors. Nucl Med Commun. 2009;30:326–32.

    Article  Google Scholar 

  26. Crivellaro C, De Ponti E, Elisei F, Morzenti S, Picchio M, Bettinardi V, et al. Added diagnostic value of respiratory-gated 4D 18F-FDG-PET/CT in the detection of liver lesions: a multicenter study. Eur J Nucl Med Mol Imaging. 2017;45:102–9.

    Article  PubMed  Google Scholar 

  27. Bar-Shalom R, Steffin D, Beny A, Kennedy J. Respiratory-gated FDG-PET/CT for detection of liver metastases of colorectal cancer. J Nucl Med. 2013;54:578.

    Google Scholar 

  28. Tatlidil R, Jadvar H, Bading JR, Conti PS. Incidental colonic fluorodeoxyglucose uptake: correlation with colonoscopic and histopathologic findings. Radiology. 2002;224:783–7.

    Article  PubMed  Google Scholar 

  29. Abouzied MM, Elpida SC, Hani AN. 18F-FDG imaging: pitfalls and artifacts. J Nucl Med Technol. 2005;33:145–55.

    PubMed  Google Scholar 

  30. Liu T, Behr S, Khan S, Osterhoff R, Aparici C. Focal colonic FDG activity with PET/CT: guidelines for recommendation of colonoscopy. World J Nucl Med. 2015;14:25–30.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Gutman F, Alberini JL, Wartski M, Vilain D, Le Stanc E, Sarandi F, et al. Incidental colonic focal lesions detected by FDG-PET/CT. Am J Roentgenol. 2005;185:495–500.

    Article  Google Scholar 

  32. Weston BR, Iyer RB, Qiao W, Lee JH, Bresalier RS, Ross WA. Ability of integrated positron emission and computed tomography to detect significant colonic pathology. Cancer. 2010;116:1454–61.

    Article  PubMed  Google Scholar 

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Acknowledgements

Part of this abstract was presented at the congress of Chubu Radiological Technology in Aichi, Japan (2022). This study was supported by the Japanese Society of Radiological Technology Chubu branch and the Chubu Nuclear Medicine Conference of Japanese Society of Radiological Technology. We would like to thank all the people involved in this study for their guidance and Ms. Ringo tadami for providing inspiration for the CMSD analysis.

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Authors and Affiliations

  1. Department of Radiology, Toyohashi Municipal Hospital, 50 Hakken-nishi, Aotake, Toyohashi, Aichi, 441-8570, Japan

    Toyohiro Kato & Hajime Ichikawa

  2. Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan

    Hajime Ichikawa & Takayuki Shibutani

  3. Radiological Center, University of Fukui Hospital, 23-3, Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan

    Akinobu Kita

  4. Department of Radiology, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan

    Masanori Watanabe

  5. Department of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Sunto, Shizuoka, 411-8777, Japan

    Hiroomi Tada

  6. Department of Radiological Technology, Kariya Toyota General Hospital, 5-15 Sumiyoshi-cho, Kariya, Aichi, 448-8505, Japan

    Akie Sugiura

  7. Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan

    Akie Sugiura

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  1. Toyohiro Kato
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  2. Hajime Ichikawa
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Correspondence to Toyohiro Kato.

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Ethical approval

This retrospective study was approved by the Ethics Committee of Toyohashi Municipal Hospital, Japan (control number: 697).

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Kato, T., Ichikawa, H., Shibutani, T. et al. A novel objective method for discriminating pathological and physiological colorectal uptake in the lower abdominal region using whole-body dynamic 18F-FDG-PET. Ann Nucl Med 37, 561–571 (2023). https://doi.org/10.1007/s12149-023-01857-6

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  • DOI: https://doi.org/10.1007/s12149-023-01857-6

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