title: [Is it useful to perform additional colonoscopy to detect unmatched lesion between positron emission tomography/computed tomography and colonoscopy?].
abstract: OBJECTIVE
  Incidentally detected focal 18F-fluorodeoxyglucose (FDG) uptake was compared with colonoscopy. We investigated the characteristics of colon adenomas which were revealed on PET/CT. Then we identified whether additional colonoscopy was necessary in patients with lesions which were revealed on PET/CT but had no matched lesions on colonoscopy.
  
  
  METHODS
  We retrospectively reviewed 95 patients who underwent colonoscopy within a 6 month interval after they had focal FDG uptake from January 2010 to May 2012 at National Police Hospital in Korea. Also, we analyzed 30 patients who underwent additional colonoscopy within 2 years after they had no matched lesions on primary colonoscopy.
  
  
  RESULTS
  PET/CT depicted 54.6% (41/75) of adenomas and adenocarcinomas. The PET visibility of colon adenoma was significantly associated with degree of dysplasia (p=0.027), histologic type (p=0.040), and the size (p=0.038). The positivity rate was increased with higher degree of dysplasia (low-grade dysplasia, 47%; high-grade dysplasia, 78%; adenocarcinoma, 100%) and villous patterns of histologic type (tubular, 46.8%; tubulovillous, 87.5%; villous, 100%). Patients with adenomas larger than 10 mm (87.5%) had higher detection rate compared to those with adenomas smaller than 10 mm (49.0%). Among the 30 patients who underwent additional colonoscopy, only one patient had a 6 mm sized tubular adenoma (low-grade dysplasia).
  
  
  CONCLUSIONS
  Incidental focal colonic uptake may indicate advanced adenoma or adenocarcinoma. Thus, it justifies performing colonoscopy for identifying the presence of colon neoplasms. However, in case of unmatched lesions between PET/CT and colonoscopy, there was little evidence that additional colonoscopy would yield benefits.
authors.affiliation: Departments of Internal Medicine, Nuclear Medicine and Pathology, National Police Hospital, Seoul, Korea.
authors.forename: Chang Yong
authors.initials: CY
authors.lastname: Yun
authors.forename: Jun-Oh
authors.initials: JO
authors.lastname: Jung
authors.forename: Seong O
authors.initials: SO
authors.lastname: Suh
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Yoo
authors.forename: Yu Mi
authors.initials: YM
authors.lastname: Oh
authors.forename: Soo Min
authors.initials: SM
authors.lastname: Ahn
authors.forename: Hyoung Hun
authors.initials: HH
authors.lastname: Sim
authors.forename: Eun Sil
authors.initials: ES
authors.lastname: Kim
authors.forename: Ji Yoon
authors.initials: JY
authors.lastname: Bae
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003111:Colonic Polyps / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18