title: PET-CT enteroclysis: a new technique for evaluation of inflammatory diseases of the intestine.
abstract: OBJECTIVE
  While CT/MR enteroclysis provides excellent anatomical details, it fails to provide information on metabolic activity of the inflammatory lesions of the intestine. We conceptualized a fusion of metabolic imaging techniques such as PET and an anatomical imaging modality such as CT enteroclysis to derive information both on morphological details and functional activity of lesions at the same time.
  
  
  METHODS
  In a prospective study, we included 17 adult patients with newly diagnosed inflammatory diseases of the intestine. Low dose whole body PET-CT scan was obtained first, which began at approximately 60 min after injection of 10 mCi of (18)fluoro-deoxyglucose (FDG). Subsequently, PET-CT enteroclysis of the abdomen was performed after infusion of 2 l of 0.5% methylcellulose through a naso-jejunal catheter.
  
  
  RESULTS
  Fourteen patients had abnormal and three had normal PET-CT enteroclysis studies. Twenty-three segments of small intestine and 27 segments of large intestine showed increased FDG uptake. The detection rate of PET-CT enteroclysis was significantly higher (total =50 segments, 23 segments of small intestine and 27 segments of large intestine) as compared with barium studies (16 segments of small intestine) and colonoscopy (17 segments of large intestine) combined together (total =33 segments). In addition PET-CT enteroclysis showed extra-luminal FDG uptake (lymph nodes in two, sacroilitis in two, and mesenteric fat proliferation in five).
  
  
  CONCLUSIONS
  As a single investigation, PET-CT enteroclysis detects a significantly higher number of lesions both in the small and large intestine in comparison to that detected by conventional barium and colonoscopy combined together. This technique is non-invasive, feasible and very promising.
authors: Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. rkphulia@hotmail.com
authors: Chandan Jyoti
authors: CJ
authors: Das
authors: Govind
authors: G
authors: Makharia
authors: Rakesh
authors: R
authors: Kumar
authors: Madhavi
authors: M
authors: Chawla
authors: Pooja
authors: P
authors: Goswami
authors: Raju
authors: R
authors: Sharma
authors: Arun
authors: A
authors: Malhotra
mesh_terms: D000293:Adolescent; D000328:Adult; D003113:Colonoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*
references: Eur J Nucl Med. 1992;19(1):14-8
references: 1547802
references: Radiographics. 2007 Jan-Feb;27(1):145-59
references: 17235004
references: J Nucl Med. 2005 Apr;46(4):587-95
references: 15809480
references: AJR Am J Roentgenol. 2004 Oct;183(4):1143-7
references: 15385321
references: Eur Radiol. 2006 Jul;16(7):1527-36
references: 16552508
references: Semin Nucl Med. 2002 Jan;32(1):47-59
references: 11839069
references: Radiology. 1998 Mar;206(3):755-60
references: 9494497
references: Gut. 2006 Jun;55(6):749-53
references: 16698746
references: Gut. 2006 May;55(5):733-41
references: 16609136
references: Gut. 1993 Oct;34(10 ):1364-9
references: 8244102
references: Am J Gastroenterol. 2002 Aug;97(8):1978-85
references: 12190164
references: Radiology. 2004 May;231(2):305-32
references: 15044750
references: Can J Gastroenterol. 1999 Jan-Feb;13(1):65-73
references: 10099817
references: Eur J Nucl Med Mol Imaging. 2002 Oct;29(10 ):1389-92
references: 12271424
references: Lancet. 1999 Sep 4;354(9181):836-7
references: 10485733
references: Radiographics. 2002 Sep-Oct;22(5):1093-107; discussion 1107-9
references: 12235339
references: AJR Am J Roentgenol. 2005 Aug;185(2):495-500
references: 16037527
references: J Nucl Med. 2005 May;46(5):758-62
references: 15872347
references: Radiology. 2002 Sep;224(3):783-7
references: 12202714
references: Inflamm Bowel Dis. 2007 Feb;13(2):164-74
references: 17206712
references: Lancet. 1997 Jul 26;350(9073):262
references: 9242806
references: Radiographics. 2005 Jul-Aug;25(4):1031-43
references: 16009822
references: AJR Am J Roentgenol. 1983 Feb;140(2):277-82
references: 6600342
references: Mol Imaging Biol. 2003 Jul-Aug;5(4):271-7
references: 14499142
references: J Nucl Med Technol. 2005 Sep;33(3):145-55; quiz 162-3
references: 16145222
references: Inflamm Bowel Dis. 2005 Aug;11(8):733-8
references: 16043988
references: Melanoma Res. 2001 Jun;11(3):297-301
references: 11468519
references: Ann N Y Acad Sci. 2006 Aug;1072:379-85
references: 17057218
references: J Nucl Med. 2004 Dec;45(12 ):2058-62
references: 15585482
references: AJR Am J Roentgenol. 2005 Dec;185(6):1575-81
references: 16304016
references: AJR Am J Roentgenol. 1996 Jul;167(1):3-15
references: 8659415
references: Cancer J. 2004 Jul-Aug;10 (4):243-50
references: 15383205
references: Clin Nucl Med. 2001 Oct;26(10 ):867
references: 11564929
references: J Nucl Med. 2001 Sep;42(9):1412-7
references: 11535734