대한핵의학회지 (1967년~2009년)
대한핵의학회지 2005;39(1)15~20
무증상 성인의 F-18-FDG PET 대장 섭취양상 : 대장내시경 소견과의 비교
(Colonic Uptake Patterns of F-18-FDG PET in Asymptomatic Adults: Comparison with Colonoscopic Findings)
Author 배문선.조유경1.정성애1.심기남1.이홍수2,
Moonsun Pai, M.D., Yoo-Kyung Cho, M.D.1, Sung-Ae Jung, M.D.1, Ki-Nam Shim, M.D.1,Hong-Soo Lee, M.D.2
Affiliation 이화여자대학교 의과대학 방사선과학교실, 내과학교실1, 가정의학과학교실2
Department of Radiology, Gastroenterology1 and Family Medicine2 College of Medicine, Ewha Womans University, Seoul, Korea
Abstract

Purpose: Physiologic intestinal FDG uptake is frequently observed in asymptomatic individuals for cancer screening FDG PET. Colonic FDG accumulation is a well-known confusing findings that interfere true cancer detection or cause false positive. The aim of this study was to evaluate the pattern and intensity of colonic uptake in whole body FDG PET in asymptomatic healthy adults and to correlate them with colonoscopic findings. Materials and Methods: We reviewed retrospectively 64 subjects (age: 27-87, M:F = 31 :33 ) who underwent both FDG PET and colonoscopy for cancer screening. FDG uptake patterns were classified as focal, segmental and diffuse. Maximum SUV were measured. The PET results were compared with colonoscopic and histologic findings. Results: In 13 patients FDG bowel uptake was interpreted as focal, in 17 patients as segmental and in 34 patients as diffuse uptake. Six adenomas (17.6%, average diameter =5.0 mm) were found in diffuse pattern, 7 adenomas (41.1%, 5.6 mm) in segmental and 4 adenomas and 1 adenocarcinoma (38.5%, 16.4 mm) in focal uptake pattern. In patients with focal uptake, four were non-adenomatous pathologic lesions (30.8%, 2 intestinal tuberculosis, 2 mucosal ulcer). There is no difference of mean SUV between patients with adenoma and with negative colonoscopic results in each group of intestinal FDG pattern (Diffuse: 1.7¡¾0.1 vs. 1.9¡¾0.5, Segmental: 4.8¡¾3.6 vs. 4.2¡¾1.2, Focal: 6.5¡¾4.7 vs. 3.5¡¾1.3). Large adenomas (>1 cm) can be detected more in the focal uptake pattern (4 out of 5) rather than in segmental (1 out of 7) or diffuse uptake (none) and had higher SUV (6.3¡¾4.8) than small adenomas (3.5¡¾3.0) (statistically insignificant). Conclusion: Focal FDG uptake is associated more often with large adenoma and other pathologic findings in colonoscopy. Segmental uptake cannot discriminate presence of adenoma from negative results, while diffuse pattern may have more chance to be normal.(Korean J Nucl Med 39(1):15-20, 2005)

Keyword F-18-FDG PET, Colonic adenoma, Colonoscopy, Cancer screening
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