Literature DB >> 24764676

Unexpected FDG-PET uptake in the gastrointestinal tract: endoscopic and histopathological correlations.

Eran Goldin1, Mahmud Mahamid1, Benjamin Koslowsky1, Shimon Shteingart1, Yael Dubner1, Gadi Lalazar1, Dov Wengrower1.   

Abstract

AIM: To investigate the nature and significance of unexpected positron emission tomography with fluorodeoxyglucose (FDG-PET) uptake within the gastrointestinal tract (GIT).
METHODS: Patients with unexpected FDG-PET findings in the GIT were evaluated. All patients had a previous confirmed malignancy, either solid or lymphoproliferative. The radiologic reports were performed by experienced radiologists with an exclusive PET expertise. Endoscopy, i.e., esophagogastroduodenoscopy (EGD) and colonoscopy, and histopathological evaluation of all findings was performed in all patients in accordance to the FDG-PET results. The findings from each of these modalities were compared to each other. Both clinically significant and insignificant findings were assessed.
RESULTS: Seventy-two patients were endoscopically evaluated. Twenty-seven patients (37.5%) had primarily a lymphoproliferative tumor and 45 (62.5%) had solid tumors. In 50 patients (69.4%) the endoscopic examination revealed lesions in the same anatomical areas as the FDG-PET findings. Among these 50 patients, malignant and premalignant lesions i.e., adenomatous polyps were found in 16 (32%) and 9 (18%) patients, respectively. Inflammation was noted in an additional 20 patients (40%). Compared to primary solid tumors, a background of primary lymphoproliferative malignancy was more likely to reveal an additional primary malignancy (15.6% vs 33.3%, respectively, P < 0.01). EGD compared to colonoscopy, revealed altogether 11 (25.6%) new malignancies compared to 5 (17.2%), respectively, P = 0.12. No GIT clinically significant findings were overseen by the FDG-PET.
CONCLUSION: Unexpected FDG uptake in the GIT is commonly encountered and may contain significant findings. Endoscopy evaluation is justified in order to detect these additional findings.

Entities:  

Keywords:  Endoscopy; Gastrointestinal tract; Malignancy; Positron emission tomography with fluorodeoxyglucose; Unexpected findings

Mesh:

Substances:

Year:  2014        PMID: 24764676      PMCID: PMC3989974          DOI: 10.3748/wjg.v20.i15.4377

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


  26 in total

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2.  Incidental anal 18fluorodeoxyglucose uptake: Should we further examine the patient?

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