title: Clinical relevance of incidental finding of focal uptakes in the colon during 18F-FDG PET/CT studies in oncology patients without known colorectal carcinoma and evaluation of the impact on management.
abstract: OBJECTIVE
  To assess the significance and the impact of focal FDG uptake in the colon in oncology patients without known colorectal carcinoma.
  
  
  METHODS
  A retrospective study was undertaken on 2,220 (18)F-FDG PET/CT studies carried out consecutively in the Nuclear Medicine Department in our hospital from 2 December 2008 to 31 May 2010. Inclusion criteria were patients with abnormal (18)F-FDG uptake in colorectal area that could not be explained (or not previously known) by their clinical histories. Patients previously diagnosed with colorectal carcinoma were excluded. A total of 86 patients (57 male, average age 63.4, range 46-85) were finally included. Colonoscopy with biopsy was established as a reference test. The impact of these findings on the diagnostic-therapeutic management in these patients was evaluated.
  
  
  RESULTS
  A colonoscopy was performed in 54 of the 86 patients, this examination not having been done up-to-date in the remaining 32 patients. Biopsy was obtained in 43 lesions of the 54 patient in whom a colonoscopy was performed. Colon disease was detected in 49 of these 54 patients, obtaining 54 FDG incidental foci which corresponded to 10 previously unsuspected primary colorectal carcinoma, 3 metastases, 27 adenomatous polyps with different degrees of dysplasia and 14 inflammatory processes. In the remaining 5 patients, the colonoscopy was normal. PET/CT modified the diagnostic and treatment management in most of the patients (49/54, that is 91%).
  
  
  CONCLUSIONS
  These results confirm the need to determine the cause of abnormal (18)F-FDG colorectal uptakes in the PET/CT studies by using colonoscopy and biopsy. This approach allows for the detection and early treatment of malignant and premalignant lesions.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Madrid, España. sguicenia@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Salazar Andía
authors.forename: A
authors.initials: A
authors.lastname: Prieto Soriano
authors.forename: A
authors.initials: A
authors.lastname: Ortega Candil
authors.forename: M N
authors.initials: MN
authors.lastname: Cabrera Martín
authors.forename: C
authors.initials: C
authors.lastname: González Roiz
authors.forename: J J
authors.initials: JJ
authors.lastname: Ortiz Zapata
authors.forename: J
authors.initials: J
authors.lastname: Cardona Arboniés
authors.forename: L
authors.initials: L
authors.lastname: Lapeña Gutiérrez
authors.forename: J L
authors.initials: JL
authors.lastname: Carreras Delgado
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000000981:diagnostic imaging* / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012007:Rectum / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18