Detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D- glucose positron emission tomography and computed tomography (FDG-PET/CT)

Tomoko Hirakawa, Jun Kato, Yoshihiro Okumura, Keisuke Hori, Sakuma Takahashi, Hideyuki Suzuki, Mitsuhiro Akita, Reiji Higashi, Shunsuke Saito, Eisuke Kaji, Toshio Uraoka, Sakiko Hiraoka, Kazuhide Yamamoto

Research output: Contribution to journalArticle

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Abstract

Background The purpose of this study was to analyze the detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT). Methods Data for a total of 492 patients who had undergone both PET/CT and colonoscopy were analyzed. After the findings of PET/CT and colonoscopy were determined independently, the results were compared in each of the six colonic sites examined in all patients. The efficacy of PET/CT was determined using colonoscopic examination as the gold standard. Results In all, 270 colorectal lesions 5 mm or more in size, including 70 pathologically confirmed malignant lesions, were found in 172 patients by colonoscopy. The sensitivity and specificity of PET/CT for detecting any of the colorectal lesions were 36 and 98%, respectively. For detecting lesions 11 mm or larger, the sensitivity was increased to 85%, with the specificity remaining consistent (97%). Moreover, the sensitivity for tumors 21 mm or larger was 96% (48/50). Tumors with malignant or high-grade pathology were likely to be positive with PET/CT. A size of 10 mm or smaller [odds ratio (OR) 44.14, 95% confidence interval (95% CI) 11.44-221.67] and flat morphology (OR 7.78, 95% CI 1.79-36.25) were significant factors that were associated with false-negative cases on PET/CT. Conclusion The sensitivity of PET/CT for detecting colorectal lesions is acceptable, showing size- and pathology-dependence, suggesting, for the most part, that clinically relevant lesions are detectable with PET/CT. However, when considering PET/CT for screening purposes caution must be exercised because there are cases of false-negative results.

Original languageEnglish
Pages (from-to)127-135
Number of pages9
JournalJournal of Gastroenterology
Volume47
Issue number2
DOIs
Publication statusPublished - Feb 2012

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Fluorine
Fluorodeoxyglucose F18
Colonoscopy
Odds Ratio
Confidence Intervals
Pathology
Neoplasms
Sensitivity and Specificity
Positron Emission Tomography Computed Tomography

Keywords

  • Cancer screening
  • Colonoscopy
  • Colorectal neoplasia
  • Computed tomography
  • Positron emission tomography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D- glucose positron emission tomography and computed tomography (FDG-PET/CT). / Hirakawa, Tomoko; Kato, Jun; Okumura, Yoshihiro; Hori, Keisuke; Takahashi, Sakuma; Suzuki, Hideyuki; Akita, Mitsuhiro; Higashi, Reiji; Saito, Shunsuke; Kaji, Eisuke; Uraoka, Toshio; Hiraoka, Sakiko; Yamamoto, Kazuhide.

In: Journal of Gastroenterology, Vol. 47, No. 2, 02.2012, p. 127-135.

Research output: Contribution to journalArticle

Hirakawa, T, Kato, J, Okumura, Y, Hori, K, Takahashi, S, Suzuki, H, Akita, M, Higashi, R, Saito, S, Kaji, E, Uraoka, T, Hiraoka, S & Yamamoto, K 2012, 'Detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D- glucose positron emission tomography and computed tomography (FDG-PET/CT)', Journal of Gastroenterology, vol. 47, no. 2, pp. 127-135. https://doi.org/10.1007/s00535-011-0473-z
Hirakawa, Tomoko ; Kato, Jun ; Okumura, Yoshihiro ; Hori, Keisuke ; Takahashi, Sakuma ; Suzuki, Hideyuki ; Akita, Mitsuhiro ; Higashi, Reiji ; Saito, Shunsuke ; Kaji, Eisuke ; Uraoka, Toshio ; Hiraoka, Sakiko ; Yamamoto, Kazuhide. / Detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D- glucose positron emission tomography and computed tomography (FDG-PET/CT). In: Journal of Gastroenterology. 2012 ; Vol. 47, No. 2. pp. 127-135.
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abstract = "Background The purpose of this study was to analyze the detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT). Methods Data for a total of 492 patients who had undergone both PET/CT and colonoscopy were analyzed. After the findings of PET/CT and colonoscopy were determined independently, the results were compared in each of the six colonic sites examined in all patients. The efficacy of PET/CT was determined using colonoscopic examination as the gold standard. Results In all, 270 colorectal lesions 5 mm or more in size, including 70 pathologically confirmed malignant lesions, were found in 172 patients by colonoscopy. The sensitivity and specificity of PET/CT for detecting any of the colorectal lesions were 36 and 98{\%}, respectively. For detecting lesions 11 mm or larger, the sensitivity was increased to 85{\%}, with the specificity remaining consistent (97{\%}). Moreover, the sensitivity for tumors 21 mm or larger was 96{\%} (48/50). Tumors with malignant or high-grade pathology were likely to be positive with PET/CT. A size of 10 mm or smaller [odds ratio (OR) 44.14, 95{\%} confidence interval (95{\%} CI) 11.44-221.67] and flat morphology (OR 7.78, 95{\%} CI 1.79-36.25) were significant factors that were associated with false-negative cases on PET/CT. Conclusion The sensitivity of PET/CT for detecting colorectal lesions is acceptable, showing size- and pathology-dependence, suggesting, for the most part, that clinically relevant lesions are detectable with PET/CT. However, when considering PET/CT for screening purposes caution must be exercised because there are cases of false-negative results.",
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T1 - Detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D- glucose positron emission tomography and computed tomography (FDG-PET/CT)

AU - Hirakawa, Tomoko

AU - Kato, Jun

AU - Okumura, Yoshihiro

AU - Hori, Keisuke

AU - Takahashi, Sakuma

AU - Suzuki, Hideyuki

AU - Akita, Mitsuhiro

AU - Higashi, Reiji

AU - Saito, Shunsuke

AU - Kaji, Eisuke

AU - Uraoka, Toshio

AU - Hiraoka, Sakiko

AU - Yamamoto, Kazuhide

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N2 - Background The purpose of this study was to analyze the detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT). Methods Data for a total of 492 patients who had undergone both PET/CT and colonoscopy were analyzed. After the findings of PET/CT and colonoscopy were determined independently, the results were compared in each of the six colonic sites examined in all patients. The efficacy of PET/CT was determined using colonoscopic examination as the gold standard. Results In all, 270 colorectal lesions 5 mm or more in size, including 70 pathologically confirmed malignant lesions, were found in 172 patients by colonoscopy. The sensitivity and specificity of PET/CT for detecting any of the colorectal lesions were 36 and 98%, respectively. For detecting lesions 11 mm or larger, the sensitivity was increased to 85%, with the specificity remaining consistent (97%). Moreover, the sensitivity for tumors 21 mm or larger was 96% (48/50). Tumors with malignant or high-grade pathology were likely to be positive with PET/CT. A size of 10 mm or smaller [odds ratio (OR) 44.14, 95% confidence interval (95% CI) 11.44-221.67] and flat morphology (OR 7.78, 95% CI 1.79-36.25) were significant factors that were associated with false-negative cases on PET/CT. Conclusion The sensitivity of PET/CT for detecting colorectal lesions is acceptable, showing size- and pathology-dependence, suggesting, for the most part, that clinically relevant lesions are detectable with PET/CT. However, when considering PET/CT for screening purposes caution must be exercised because there are cases of false-negative results.

AB - Background The purpose of this study was to analyze the detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT). Methods Data for a total of 492 patients who had undergone both PET/CT and colonoscopy were analyzed. After the findings of PET/CT and colonoscopy were determined independently, the results were compared in each of the six colonic sites examined in all patients. The efficacy of PET/CT was determined using colonoscopic examination as the gold standard. Results In all, 270 colorectal lesions 5 mm or more in size, including 70 pathologically confirmed malignant lesions, were found in 172 patients by colonoscopy. The sensitivity and specificity of PET/CT for detecting any of the colorectal lesions were 36 and 98%, respectively. For detecting lesions 11 mm or larger, the sensitivity was increased to 85%, with the specificity remaining consistent (97%). Moreover, the sensitivity for tumors 21 mm or larger was 96% (48/50). Tumors with malignant or high-grade pathology were likely to be positive with PET/CT. A size of 10 mm or smaller [odds ratio (OR) 44.14, 95% confidence interval (95% CI) 11.44-221.67] and flat morphology (OR 7.78, 95% CI 1.79-36.25) were significant factors that were associated with false-negative cases on PET/CT. Conclusion The sensitivity of PET/CT for detecting colorectal lesions is acceptable, showing size- and pathology-dependence, suggesting, for the most part, that clinically relevant lesions are detectable with PET/CT. However, when considering PET/CT for screening purposes caution must be exercised because there are cases of false-negative results.

KW - Cancer screening

KW - Colonoscopy

KW - Colorectal neoplasia

KW - Computed tomography

KW - Positron emission tomography

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