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FDG-PET-CT Enterography Helps Determine Clinical Significance of Suspected Ileocecal Thickening: A Prospective Study
- Source :
- Digestive diseases and sciences. 66(5)
- Publication Year :
- 2020
-
Abstract
- Ileocecal thickening (ICT) on imaging could result from diverse etiologies but may also be clinically insignificant. Evaluation of role of combined 2-deoxy-2-fluorine-18-fluoro-d-glucose(18F-FDG)-positron emission tomography and computed tomographic enterography (PET–CTE) for determination of clinical significance of suspected ICT. This prospective study enrolled consecutive patients with suspected ICT on ultrasound. Patients were evaluated with PET–CTE and colonoscopy. The patients were divided into: Group A (clinically significant diagnosis) or Group B (clinically insignificant diagnosis) and compared for various clinical and radiological findings. The two groups were compared for maximum standardized uptake values of terminal ileum, ileo-cecal valve, cecum and overall. Of 34 patients included (23 males, mean age: 40.44 ± 15.40 years), 12 (35.3%) had intestinal tuberculosis, 11 (32.4%) Crohn’s disease, 3 (8.8%) other infections, 1 (2.9%) malignancy, 4 (11.8%) non-specific terminal ileitis while 3 (8.8%) had normal colonoscopy and histology. The maximum standardized uptake value of the ileocecal area overall (SUVmax-ICT-overall) was significantly higher in Group A (7.16 ± 4.38) when compared to Group B (3.62 ± 9.50, P = 0.003). A cut-off of 4.50 for SUVmax-ICT-overall had a sensitivity of 70.37% and a specificity of 100% for prediction of clinically significant diagnosis. Using decision tree model, the SUVmax-ICT with a cut-off of 4.75 was considered appropriate for initial decision followed by the presence of mural thickening in the next node. PET–CTE can help in discrimination of clinically significant and insignificant diagnosis. It may help guide the need for colonoscopy in patients suspected to have ICT on CT.
- Subjects :
- Adult
Male
medicine.medical_specialty
Physiology
Biopsy
Clinical Decision-Making
Colonoscopy
Standardized uptake value
Malignancy
03 medical and health sciences
Cecum
Ileocecal valve
Young Adult
0302 clinical medicine
Crohn Disease
Fluorodeoxyglucose F18
Predictive Value of Tests
Internal medicine
Positron Emission Tomography Computed Tomography
Intestinal Neoplasms
Medicine
Humans
Clinical significance
Prospective Studies
Prospective cohort study
Ileocecal Valve
medicine.diagnostic_test
business.industry
Decision Trees
Gastroenterology
Hepatology
Ileitis
Middle Aged
medicine.disease
medicine.anatomical_structure
Tuberculosis, Gastrointestinal
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Female
Radiology
Radiopharmaceuticals
business
Subjects
Details
- ISSN :
- 15732568
- Volume :
- 66
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Digestive diseases and sciences
- Accession number :
- edsair.doi.dedup.....3a3c3e60123ac9fb40f0af7099ff2836