Limited identification of dual-time-point positron emission tomography/computed tomography in advanced colorectal neoplasms

Kazuhiro Kashiwagi, Yoshihiro Nakazato, Mari Arai, Eisuke Iwasaki, Makoto Naganuma, Nagamu Inoue, Yasushi Iwao, Haruhiko Ogata, Koji Murakami, Takanori Kanai

Research output: Contribution to journalArticle

Abstract

Objective We investigated whether dual-time-point 18-Fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) could improve the positive predictive value for detecting advanced colorectal neoplasms (cancer, adenoma ≥110 mm or adenoma with high-grade dysplasia). Methods We retrospectively searched for consecutive patients with a known primary cancer, who had a colonic18FDG uptake incidentally found by PET/CT, followed by colonoscopy between January 2013 and August 2014. The clinical characteristics including the maximum standardized uptake value (SUVmax) were compared between advanced colorectal neoplasms and non-advanced lesions. Results Forty-eight patients had 51 foci with an incidental focal colorectal uptake of18FDG. Among these 51 foci, 28 foci were judged as being advanced neoplasms, whereas 23 foci identified as non-advanced lesions. Four cases were missed by PET/CT: two laterally spreading tumors (LSTs) with intramucosal cancer and two severe adenomas (<10 mm). The positive predictive value for the detection of advanced neoplasms was 55%. The per-spot performance of PET/CT showed that SUVmax was significantly higher in advanced neoplasms than in non-advanced lesions for the early-phase (10.1±4.9 vs. 6.5±3.2, p=0.029) and the delayed-phase (12.0±6.0 vs. 7.4±4.0, p=0.022). However, more importantly, there was a significant overlap of the SUVmax and no significant difference was found in the retention index (19.2±20.1 vs. 16.6±29.4, p=0.767). Conclusion Dual-time-point PET/CT was found to have limited impact for identifying advanced colorectal neoplasms in spite of its high sensitivity and it might therefore not be able to identify either LSTs or small advanced neoplasms.

Original languageEnglish
Pages (from-to)1287-1292
Number of pages6
JournalInternal Medicine
Volume56
Issue number11
DOIs
Publication statusPublished - 2017

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Colorectal Neoplasms
Neoplasms
Adenoma
Positron Emission Tomography Computed Tomography
Colonoscopy

Keywords

  • Advanced colorectal neoplasms
  • Colonoscopy
  • Dual-time-point PET/CT

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Limited identification of dual-time-point positron emission tomography/computed tomography in advanced colorectal neoplasms. / Kashiwagi, Kazuhiro; Nakazato, Yoshihiro; Arai, Mari; Iwasaki, Eisuke; Naganuma, Makoto; Inoue, Nagamu; Iwao, Yasushi; Ogata, Haruhiko; Murakami, Koji; Kanai, Takanori.

In: Internal Medicine, Vol. 56, No. 11, 2017, p. 1287-1292.

Research output: Contribution to journalArticle

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abstract = "Objective We investigated whether dual-time-point 18-Fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) could improve the positive predictive value for detecting advanced colorectal neoplasms (cancer, adenoma ≥110 mm or adenoma with high-grade dysplasia). Methods We retrospectively searched for consecutive patients with a known primary cancer, who had a colonic18FDG uptake incidentally found by PET/CT, followed by colonoscopy between January 2013 and August 2014. The clinical characteristics including the maximum standardized uptake value (SUVmax) were compared between advanced colorectal neoplasms and non-advanced lesions. Results Forty-eight patients had 51 foci with an incidental focal colorectal uptake of18FDG. Among these 51 foci, 28 foci were judged as being advanced neoplasms, whereas 23 foci identified as non-advanced lesions. Four cases were missed by PET/CT: two laterally spreading tumors (LSTs) with intramucosal cancer and two severe adenomas (<10 mm). The positive predictive value for the detection of advanced neoplasms was 55{\%}. The per-spot performance of PET/CT showed that SUVmax was significantly higher in advanced neoplasms than in non-advanced lesions for the early-phase (10.1±4.9 vs. 6.5±3.2, p=0.029) and the delayed-phase (12.0±6.0 vs. 7.4±4.0, p=0.022). However, more importantly, there was a significant overlap of the SUVmax and no significant difference was found in the retention index (19.2±20.1 vs. 16.6±29.4, p=0.767). Conclusion Dual-time-point PET/CT was found to have limited impact for identifying advanced colorectal neoplasms in spite of its high sensitivity and it might therefore not be able to identify either LSTs or small advanced neoplasms.",
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T1 - Limited identification of dual-time-point positron emission tomography/computed tomography in advanced colorectal neoplasms

AU - Kashiwagi, Kazuhiro

AU - Nakazato, Yoshihiro

AU - Arai, Mari

AU - Iwasaki, Eisuke

AU - Naganuma, Makoto

AU - Inoue, Nagamu

AU - Iwao, Yasushi

AU - Ogata, Haruhiko

AU - Murakami, Koji

AU - Kanai, Takanori

PY - 2017

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N2 - Objective We investigated whether dual-time-point 18-Fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) could improve the positive predictive value for detecting advanced colorectal neoplasms (cancer, adenoma ≥110 mm or adenoma with high-grade dysplasia). Methods We retrospectively searched for consecutive patients with a known primary cancer, who had a colonic18FDG uptake incidentally found by PET/CT, followed by colonoscopy between January 2013 and August 2014. The clinical characteristics including the maximum standardized uptake value (SUVmax) were compared between advanced colorectal neoplasms and non-advanced lesions. Results Forty-eight patients had 51 foci with an incidental focal colorectal uptake of18FDG. Among these 51 foci, 28 foci were judged as being advanced neoplasms, whereas 23 foci identified as non-advanced lesions. Four cases were missed by PET/CT: two laterally spreading tumors (LSTs) with intramucosal cancer and two severe adenomas (<10 mm). The positive predictive value for the detection of advanced neoplasms was 55%. The per-spot performance of PET/CT showed that SUVmax was significantly higher in advanced neoplasms than in non-advanced lesions for the early-phase (10.1±4.9 vs. 6.5±3.2, p=0.029) and the delayed-phase (12.0±6.0 vs. 7.4±4.0, p=0.022). However, more importantly, there was a significant overlap of the SUVmax and no significant difference was found in the retention index (19.2±20.1 vs. 16.6±29.4, p=0.767). Conclusion Dual-time-point PET/CT was found to have limited impact for identifying advanced colorectal neoplasms in spite of its high sensitivity and it might therefore not be able to identify either LSTs or small advanced neoplasms.

AB - Objective We investigated whether dual-time-point 18-Fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) could improve the positive predictive value for detecting advanced colorectal neoplasms (cancer, adenoma ≥110 mm or adenoma with high-grade dysplasia). Methods We retrospectively searched for consecutive patients with a known primary cancer, who had a colonic18FDG uptake incidentally found by PET/CT, followed by colonoscopy between January 2013 and August 2014. The clinical characteristics including the maximum standardized uptake value (SUVmax) were compared between advanced colorectal neoplasms and non-advanced lesions. Results Forty-eight patients had 51 foci with an incidental focal colorectal uptake of18FDG. Among these 51 foci, 28 foci were judged as being advanced neoplasms, whereas 23 foci identified as non-advanced lesions. Four cases were missed by PET/CT: two laterally spreading tumors (LSTs) with intramucosal cancer and two severe adenomas (<10 mm). The positive predictive value for the detection of advanced neoplasms was 55%. The per-spot performance of PET/CT showed that SUVmax was significantly higher in advanced neoplasms than in non-advanced lesions for the early-phase (10.1±4.9 vs. 6.5±3.2, p=0.029) and the delayed-phase (12.0±6.0 vs. 7.4±4.0, p=0.022). However, more importantly, there was a significant overlap of the SUVmax and no significant difference was found in the retention index (19.2±20.1 vs. 16.6±29.4, p=0.767). Conclusion Dual-time-point PET/CT was found to have limited impact for identifying advanced colorectal neoplasms in spite of its high sensitivity and it might therefore not be able to identify either LSTs or small advanced neoplasms.

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