Clinical utility of positron emission tomography/computed tomography in inflammatory bowel disease.
OBJECTIVE
The clinical utility of positron emission tomography/computed tomography (PET/CT) in comparison to standard workup in patients with known or suspected inflammatory bowel disease (IBD) is unknown.


METHODS
Clinical data were collected on seven patients with known or suspected IBD undergoing PET/CT. Standard workup included history, physical exam, laboratory tests, colonoscopy and/or cross-sectional imaging. We divided the intestine into five regions [small bowel and four colon (ascending, transverse, descending and rectosigmoid)] and graded relative standard uptake values 0, 1, 2 or 3 by comparison to the liver, using a region-of-interest analysis (0 = no activity, 1 = liver, 2 and 3 = significant inflammation).


RESULTS
In patients 1 and 2, PET/CT demonstrated more activity than we thought clinically present. The other patients avoided unnecessary escalation or initiation of IBD therapy based on PET/CT results. Compared with standard workup, all seven patients had superior results when therapeutic decisions were based on PET/CT.


CONCLUSIONS
We found PET/CT to be very useful in diagnosis and management in patients with known or suspected IBD.
Lapp
Robert T
RT
Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Spier
Bret J
BJ
Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Perlman
Scott B
SB
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Jaskowiak
Christine J
CJ
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Reichelderfer
Mark
M
Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. mxr@medicine.wisc.edu.
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome