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Detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-d-glucose positron emission tomography and computed tomography (FDG-PET/CT)

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Abstract

Background

The purpose of this study was to analyze the detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT).

Methods

Data for a total of 492 patients who had undergone both PET/CT and colonoscopy were analyzed. After the findings of PET/CT and colonoscopy were determined independently, the results were compared in each of the six colonic sites examined in all patients. The efficacy of PET/CT was determined using colonoscopic examination as the gold standard.

Results

In all, 270 colorectal lesions 5 mm or more in size, including 70 pathologically confirmed malignant lesions, were found in 172 patients by colonoscopy. The sensitivity and specificity of PET/CT for detecting any of the colorectal lesions were 36 and 98%, respectively. For detecting lesions 11 mm or larger, the sensitivity was increased to 85%, with the specificity remaining consistent (97%). Moreover, the sensitivity for tumors 21 mm or larger was 96% (48/50). Tumors with malignant or high-grade pathology were likely to be positive with PET/CT. A size of 10 mm or smaller [odds ratio (OR) 44.14, 95% confidence interval (95% CI) 11.44–221.67] and flat morphology (OR 7.78, 95% CI 1.79–36.25) were significant factors that were associated with false-negative cases on PET/CT.

Conclusion

The sensitivity of PET/CT for detecting colorectal lesions is acceptable, showing size- and pathology-dependence, suggesting, for the most part, that clinically relevant lesions are detectable with PET/CT. However, when considering PET/CT for screening purposes caution must be exercised because there are cases of false-negative results.

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Acknowledgments

We thank all staff members (Department of Gastroenterology and Hepatology, and Department of Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences) for providing baseline data and for their helpful discussions.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Tomoko Hirakawa, Sakuma Takahashi, Hideyuki Suzuki, Mitsuhiro Akita, Reiji Higashi, Shunsuke Saito, Eisuke Kaji, Sakiko Hiraoka & Kazuhide Yamamoto

  2. Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-0012, Japan

    Jun Kato

  3. Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Yoshihiro Okumura

  4. Department of Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Keisuke Hori

  5. Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Toshio Uraoka

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  1. Tomoko Hirakawa
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  2. Jun Kato
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Corresponding author

Correspondence to Tomoko Hirakawa.

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Hirakawa, T., Kato, J., Okumura, Y. et al. Detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-d-glucose positron emission tomography and computed tomography (FDG-PET/CT). J Gastroenterol 47, 127–135 (2012). https://doi.org/10.1007/s00535-011-0473-z

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  • DOI: https://doi.org/10.1007/s00535-011-0473-z

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