For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
107
views
36
references
 Top references
cited by
17
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    23
    shares
      171
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prevalence and malignancy risk of focal colorectal incidental uptake detected by 18F-FDG-PET or PET/CT: a meta-analysis

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The aim of the study was to meta-analyze published data about prevalence and malignancy risk of focal colorectal incidentalomas (FCIs) detected by Fluorine-18-Fluorodeoxyglucose positron emission tomography or positron emission tomography/computed tomography ( 18F-FDG-PET or PET/CT).

          Methods

          A comprehensive computer literature search of studies published through July 31 st 2012 regarding FCIs detected by 18F-FDG-PET or PET/CT was performed. Pooled prevalence of patients with FCIs and risk of malignant or premalignant FCIs after colonoscopy or histopathology verification were calculated. Furthermore, separate calculations for geographic areas were performed. Finally, average standardized uptake values (SUV) in malignant, premalignant and benign FCIs were reported.

          Results

          Thirty-two studies comprising 89,061 patients evaluated by 18F-FDG-PET or PET/CT were included. The pooled prevalence of FCIs detected by 18F-FDG-PET or PET/CT was 3.6% (95% confidence interval [95% CI]: 2.6–4.7%). Overall, 1,044 FCIs detected by 18F-FDG-PET or PET/CT underwent colonoscopy or histopathology evaluation. Pooled risk of malignant or premalignant lesions was 68% (95% CI: 60–75%). Risk of malignant and premalignant FCIs in Asia-Oceania was lower compared to that of Europe and America. A significant overlap in average SUV was found between malignant, premalignant and benign FCIs.

          Conclusions

          FCIs are observed in a not negligible number of patients who undergo 18F-FDG-PET or PET/CT studies with a high risk of malignant or premalignant lesions. SUV is not reliable as a tool to differentiate between malignant, premalignant and benign FCIs. Further investigation is warranted whenever FCIs are detected by 18F-FDG-PET or PET/CT.

          Related collections

          Most cited references36

          • Record: found
          • Abstract: found
          • Article: not found

          Detection of unexpected additional primary malignancies with PET/CT.

          Takayoshi Ishimori, R Wahl, Kushang V. Patel (2005)
          This study evaluated the yield of whole-body (18)F-FDG PET/CT for the detection of unexpected (18)F-FDG-avid additional primary malignant tumors in patients being evaluated by PET/CT for known or suspected malignances. Reports from whole-body (18)F-FDG PET/CT scans from June 2001 to June 2003 were reviewed, and 1,912 patients (924 men and 988 women; mean age +/- SD, 58.9 +/- 13.9 y) who had been scanned for known or suspected malignant lesions were included in this study. The sites of known or suspected primary tumors included lung (28.6%), colon or rectum (12.4%), head or neck (12.1%), lymph nodes (10.9%), breast (7.6%), gynecologic organs (7.1%), genitourinary organs (4.2%), esophagus (3.6%), skin (melanoma) (3.5%), pancreas (2.5%), bone or soft tissue (2.2%), and other sites (5.4%). Lesions that were newly discovered on PET/CT, had not been previously detected by other modalities, and were atypical in location for metastases on the PET/CT study were interpreted as suggestive of a new primary malignant tumor. These abnormalities were compared with the final diagnosis obtained from the medical records, including pathologic reports. PET-positive lesions suggestive of new primary malignant tumors were found in 79 (4.1%) of 1,912 patients. In 22 (1.2%) of 1,912 patients, these lesions were pathologically proven to be malignant. Proven sites were lung (7 lesions), thyroid (6 lesions), colon (4 lesions), breast (2 lesions), esophagus (2 lesions), bile duct (1 lesion), and head and neck other than thyroid (1 lesion). Two new lesions in the lung and the thyroid were proven malignant in 1 patient. In 17 patients, the treatment plan was changed and the new lesion was surgically resected after the PET/CT examination. In 10 patients, PET was falsely positive after pathologic assessment. False-positive sites included thyroid (5 lesions), uterus (2 lesions), head and neck other than thyroid (2 lesions), and lung (1 lesion). In 8 patients, the PET-positive lesions were considered benign after clinical follow-up of at least 8 mo. In 39 patients, the follow-up record was not yet available and the final diagnosis of the detected lesion has not yet been resolved. Whole-body PET/CT detected new, unexpected (18)F-FDG-avid primary malignant tumors in at least 1.2% of patients with cancer.
          Article 0 comments Cited 42 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            PET/CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence, localization patterns, and clinical significance.

            Rachel Bar-Shavit, Alex Frenkel, Ora Israel … (2005)
            Precise PET/CT localization of focal (18)F-FDG uptake in the gastrointestinal tract (GIT) may exclude malignancy in sites of physiologic activity but may also induce false-negative reports for malignant or premalignant lesions. The purpose of the present study was to retrospectively evaluate the nature and significance of unexpected focal (18)F-FDG uptake localized by PET/CT within the GIT. The files of 4,390 patients referred for (18)F-FDG PET/CT were retrospectively reviewed. The incidence of studies showing unexpected focal uptake of (18)F-FDG localized by PET/CT to the GIT was determined. The position of these foci along the GIT and their intensity were recorded. The etiology of the findings was confirmed histologically or by long-term follow-up. Unexpected focal (18)F-FDG uptake in the GIT was found in 58 patients (1.3%). Follow-up data were available for 34 of these patients, including 4 with sites in the stomach, 2 in the small bowel, and 28 in the colon. GIT-related disease was confirmed in 24 patients (71%). There were 11 malignant tumors, 9 premalignant lesions, and 4 benign processes including 2 benign polyps, 1 case of active gastritis, and 1 abscess of the sigmoid. Ten patients (29%) had no further evidence of GIT abnormality, and the suggestive sites were considered to be physiologic uptake. Maximal standardized uptake value was 17.3 +/- 10.2 in malignant lesions, 14.0 +/- 10.5 in premalignant lesions, 18.0 +/- 12.1 in benign lesions, and 11.1 +/- 7.4 in foci of physiologic (18)F-FDG uptake in the GIT, with no statistically significant difference among the 4 subgroups. Incidental focal (18)F-FDG uptake localized by PET/CT within the GIT is of clinical significance in most patients. These findings should be followed up with appropriate invasive procedures guided by hybrid imaging results.
            Article 0 comments Cited 31 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Incidental colonic fluorodeoxyglucose uptake: correlation with colonoscopic and histopathologic findings.

              Hossein Jadvar, James Bading, R Tatlidil … (2002)
              To evaluate the pattern and degree of incidental colonic fluorodeoxyglucose (FDG) uptake in patients without colorectal carcinoma who underwent whole-body FDG positron emission tomography (PET) for other purposes and compare them with colonoscopic and/or histopathologic findings. Cases of 27 patients without known history of colorectal carcinoma who were referred for evaluation with whole-body FDG PET and displayed incidental colonic uptake were reviewed retrospectively. Colonoscopy was performed in 10 patients; histopathologic analysis, in two; and both, in 15. The colonic FDG uptake patterns were nodular-focal, nodular-multifocal, segmental, and diffuse. The FDG uptake level was scored with a four-point scale in relation to hepatic uptake. Binomial distribution was used to calculate 95% CIs for the probability of finding an abnormality at histologic examination, as predicted by findings at FDG PET. Colonoscopic findings in eight patients with a diffuse uptake pattern were normal. Thirteen patients with nodular high FDG uptake had pathologic findings. Six (22%) of the 27 patients were not suspected of having a malignancy, and seven had benign neoplasms. With a 95% CI, nodular high FDG uptake implies at least a 79% chance that histopathologic findings may be abnormal. Colitis was seen in five of six patients with a segmental pattern of high FDG uptake. Colonoscopy is a reasonable next step for further diagnostic examination of patients who display nodular high FDG uptake in the colon. Diffuse FDG uptake often is associated with normal findings at colonoscopy, while segmental high uptake may imply inflammation. Copyright RSNA, 2002
              Article 0 comments Cited 29 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Radiol Oncol
                Journal ID (iso-abbrev): Radiol Oncol
                Journal ID (publisher-id): RADO
                Title: Radiology and Oncology
                Publisher: Versita, Warsaw
                ISSN (Print): 1318-2099
                ISSN (Electronic): 1581-3207
                Publication date Collection: June 2014
                Publication date (Electronic): 25 April 2014
                Volume: 48
                Issue: 2
                Pages: 99-104
                Affiliations
                [1 ] Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
                [2 ] Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy
                [3 ] Institute of Radiology, Catholic University of the Sacred Heart, Rome, Italy
                [4 ] School of Medicine, Catholic University of the Sacred Heart, Rome, Italy
                [5 ] Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad
                Author notes
                Correspondence to: Giorgio Treglia, M.D., Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Via Ospedale 12, CH-6500 Bellinzona, Switzerland. Telephone: +41918118919; Fax: +41918118250; E-mail: giorgiomednuc@ 123456libero.it
                Article
                Publisher ID: rado-48-02-99
                DOI: 10.2478/raon-2013-0035
                PMC ID: 4078042
                PubMed ID: 24991198
                SO-VID: f6dd9afe-4137-4796-b549-32d067d6a018
                Copyright © Copyright © by Association of Radiology & Oncology
                License:

                This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                Date received : 18 December 2012
                Date accepted : 01 May 2013
                Categories
                Subject: Review

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: pet/ct,fluorodeoxyglucose,colonic uptake,incidentaloma,focal uptake,colorectal cancer
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: pet/ct, fluorodeoxyglucose, colonic uptake, incidentaloma, focal uptake, colorectal cancer

                Comments

                Comment on this article

                scite_

                Similar content171

                See all similar

                Cited by16

                See all cited by

                Most referenced authors410

                See all reference authors