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Clinical significance of incidental 18FDG PET uptake in the gastrointestinal tract: a retrospective cohort study.
- Source :
-
Internal Medicine Journal . Sep2023, Vol. 53 Issue 9, p1670-1677. 8p. - Publication Year :
- 2023
-
Abstract
- Background: Incidental gastrointestinal tract (GIT) uptake is found in up to 6.3% of patients undergoing positron emission tomography (PET). This may be physiologic or pathologic and requires endoscopic assessment. Aim: To determine the diagnostic yield of endoscopy in this setting and characterise PET avidity as a predictor of clinically significant findings. Methods: We retrospectively reviewed all consecutive patients undergoing upper endoscopy or colonoscopy for incidental 18FDG PET positivity in the GIT. Results: A total of 255 patients (62% male, median age 67 years) underwent colonoscopy or sigmoidoscopy for 276 separate areas of PET avidity in the colon. Malignancy was found in 44 cases (16%), and a significant polyp was found in an additional 103 cases (37%). Neoplastic change was found more often in the case of intense compared with non‐intense PET avidity (odds ratio (OR) 3.40, 95% confidence interval (CI) 1.95–5.93, P < 0.001), and in focal compared with diffuse uptake (OR 5.97, 95% CI 2.9–12.2, P < 0.001). Upper GIT endoscopy was performed in 75 patients (46 male, median age 63 years) for 77 isolated areas with PET avidity. Malignancy was found in 16 cases (21%), and all were new primary lesions. Numerically, malignant findings were more common in intense (29.7%) than non‐intense (12.5%) PET avidity (OR 2.96, 95%, CI 0.92–9.57, P = 0.069). Conclusions: Both focal and intense colonic 18FDG uptake correlate strongly with a high‐risk polyp or malignant lesion. Up to 21% of all gastroscopies performed for evaluation of incidental PET uptake diagnosed a new primary malignancy. These referrals need appropriate triaging and timely endoscopic assessment. [ABSTRACT FROM AUTHOR]
- Subjects :
- *GASTROINTESTINAL disease diagnosis
*GASTROINTESTINAL system
*STATISTICAL significance
*COLONOSCOPY
*PREDICTIVE tests
*CONFIDENCE intervals
*ENDOSCOPIC surgery
*RETROSPECTIVE studies
*COLORECTAL cancer
*POSITRON emission tomography
*MEDICAL records
*CHI-squared test
*DESCRIPTIVE statistics
*STATISTICAL correlation
*SENSITIVITY & specificity (Statistics)
*LOGISTIC regression analysis
*ODDS ratio
*ENDOSCOPY
*LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 14440903
- Volume :
- 53
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Internal Medicine Journal
- Publication Type :
- Academic Journal
- Accession number :
- 172302053
- Full Text :
- https://doi.org/10.1111/imj.16002