Korean Journal of Radiology

  • 제14권6호
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  • Pages.951-959
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  • 2013
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Is There Any Additional Benefit of Contrast-Enhanced CT as Part of Routine PET/CT Protocols for the Differentiation of Suspicious Incidental Gastrointestinal 2-Deoxy-$^{18}F$-FDG Uptake?

  • Brendle, Cornelia Bettina (Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tuebingen) ;
  • Aschoff, Philip (Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tuebingen) ;
  • Kratt, Thomas (Department of Surgery, University Hospital Tuebingen) ;
  • Schraml, Christina (Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tuebingen) ;
  • Reimold, Matthias (Department of Radiology, Nuclear Medicine, University Hospital Tuebingen) ;
  • Claussen, Claus Detlef (Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tuebingen) ;
  • Pfannenberg, Christina Anna (Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tuebingen)
  • 투고 : 2013.01.28
  • 심사 : 2013.08.06
  • 발행 : 2013.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: Suspicious incidental gastrointestinal FDG uptake during positron-emission tomography/computed tomography (PET/CT) examinations can be caused by different diseases, including malignancies. However, differentiation with PET alone is difficult. The aim of this study was to investigate the potential of PET alone, contrast-enhanced CT (ceCT), and low-dose CT (ldCT) in routine PET/CT protocols for differentiation of incidental gastrointestinal lesions. Materials and Methods: Sixty patients with incidental gastrointestinal lesions who underwent a routine PET/CT protocol with ldCT and ceCT were retrospectively analysed. The PET lesions were evaluated regarding their FDG uptake patterns and the standard uptake value. The anatomical correlates in both CT protocols were compared in regard to the correct lesion classification with the reference standard endoscopy. Results: Sixty-two lesions were found in 60 patients (17 malignant, 10 premalignant, 5 benign, 13 inflammatory, 17 physiological). The differentiation of the FDG uptake patterns did not enable reliable lesion classification. The positive predictive value for pathology was 0.81 for ceCT in PET/CT and 0.70 for ldCT. Malignancies were detected in 100% of the patients by ceCT vs. 29.4% by ldCT. The false negative rate of ceCT for all pathologies was 31.1%, vs. 68.9% for ldCT. False positive results (17/62) could not be excluded sufficiently by either CT protocol. Conclusion: PET/ceCT protocols provide additional benefit especially in detecting gastrointestinal malignancies as a cause of suspicious incidental gastrointestinal FDG uptake. However, since follow-up endoscopy cannot be forgone due to the considerable false negative rate even with ceCT, the addition of ceCT to a routine PET/ldCT protocol cannot be recommended for this purpose.

키워드

참고문헌

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피인용 문헌

  1. Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin vol.30, pp.3, 2013, https://doi.org/10.4103/0972-3919.158529