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Incidental 18F-FDG uptake in the colon: value of contrast-enhanced CT correlation with colonoscopic findings.

Julian KirchnerBenedikt M SchaarschmidtFiras KourLino M SawickiOle MartinJohannes BodeStephan Vom DahlVerena KeitelDieter HäussingerChristina AntkeChristian BuchbenderGerald AntochPhilipp Heusch
Published in: European journal of nuclear medicine and molecular imaging (2019)
In 38.4% (48/125) of the patients, a focal 18F-FDG uptake was observed within 67 lesions. Malignant lesions were endoscopically and histopathologically diagnosed in eleven patients, and nine of these were detected by focal 18F-FDG uptake. A total of 34 lesions with impact on short- or long-term patient management (either being pre- or malignant) were detected. Sensitivity, Specificity, PPV, NPV, and accuracy for sole 18F-FDG uptake for this combined group were 54%, 69%, 29%, 85%, and 65%. Corresponding results for focal 18F-FDG uptake with correlating CT findings were 38%, 90%, 50%, 86%, and 80%. This resulted in a statistically significant difference for diagnostic accuracy (p = 0.0001) CONCLUSION: By analyzing additional morphological changes in contrast-enhanced CT imaging, the specificity of focal colonic 18F-FDG uptake for precancerous and cancerous lesions can be increased but leads to a considerate loss of sensitivity. Therefore, every focal colonic uptake should be followed up by colonoscopy.
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