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KMID : 0614620130610060319
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Korean Journal of Gastroenterology
2013 Volume.61 No. 6 p.319 ~ p.326
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Is It Useful to Perform Additional Colonoscopy to Detect Unmatched Lesion between Positron Emission Tomography/Computed Tomography and Colonoscopy?
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Yun Chang-Yong
Jung Jun-Oh
Suh Seong-O
Yoo Ji-Won
Oh Yu-Mi
Ahn Soo-Min
Sim Hyoung-Hun
Kim Eun-Sil
Bae Ji-Yoon
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Abstract
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Background/Aims: 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. (Korean J Gastroenterol 2013;61:319-326)
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KEYWORD
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Positron-emission tomography and computed tomography, Colonic neoplasms, Colonoscopy
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