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DOI: 10.1148/radiol.2243011214
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(Radiology 2002;224:783-787.)
© RSNA, 2002

Nuclear Medicine

Incidental Colonic Fluorodeoxyglucose Uptake: Correlation with Colonoscopic and Histopathologic Findings1

Rozet Tatlidil, MD2, Hossein Jadvar, MD, PhD, James R. Bading, PhD and Peter S. Conti, MD, PhD

1 From the PET Imaging Science Center, Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine, University of Southern California, 2250 Alcazar St, Suite 101, Los Angeles, CA 90033-4609. From the 2000 RSNA scientific assembly. Received July 17, 2001; revision requested September 10; revision received November 2; accepted January 7, 2002. Address correspondence to P.S.C. (e-mail: pconti@.usc.edu).


   ABSTRACT
TOP
 ABSTRACT
INTRODUCTION
 MATERIALS AND METHODS
RESULTS
 DISCUSSION
 REFERENCES
 
PURPOSE: To evaluate the pattern and degree of incidental colonic fluorodeoxyglucose (FDG) uptake in patients without colorectal carcinoma who underwent whole-body FDG positron emission tomography (PET) for other purposes and compare them with colonoscopic and/or histopathologic findings.

MATERIALS AND METHODS: Cases of 27 patients without known history of colorectal carcinoma who were referred for evaluation with whole-body FDG PET and displayed incidental colonic uptake were reviewed retrospectively. Colonoscopy was performed in 10 patients; histopathologic analysis, in two; and both, in 15. The colonic FDG uptake patterns were nodular-focal, nodular-multifocal, segmental, and diffuse. The FDG uptake level was scored with a four-point scale in relation to hepatic uptake. Binomial distribution was used to calculate 95% CIs for the probability of finding an abnormality at histologic examination, as predicted by findings at FDG PET.

RESULTS: Colonoscopic findings in eight patients with a diffuse uptake pattern were normal. Thirteen patients with nodular high FDG uptake had pathologic findings. Six (22%) of the 27 patients were not suspected of having a malignancy, and seven had benign neoplasms. With a 95% CI, nodular high FDG uptake implies at least a 79% chance that histopathologic findings may be abnormal. Colitis was seen in five of six patients with a segmental pattern of high FDG uptake.

CONCLUSION: Colonoscopy is a reasonable next step for further diagnostic examination of patients who display nodular high FDG uptake in the colon. Diffuse FDG uptake often is associated with normal findings at colonoscopy, while segmental high uptake may imply inflammation.

© RSNA, 2002

Index terms: Cancer screening • Colon neoplasms, 75.32 • Colonoscopy • Colon, PET, 75.12163 • Positron emission tomography (PET), 75.12163


   INTRODUCTION
TOP
 ABSTRACT
 INTRODUCTION
MATERIALS AND METHODS
RESULTS
 DISCUSSION
 REFERENCES
 
Incidental colonic fluorodeoxyglucose (FDG) uptake often is observed in patients who undergo positron emission tomography (PET) studies. The mechanism of FDG uptake in the colon is unclear, and the factors that influence the level and pattern of uptake are unknown (1,2). The observed colonic FDG uptake can vary from mild to moderate to occasionally intense. FDG localization in the cecum and the ascending colon is higher than it is in the other colonic segments (3,4). High diffuse uptake hinders lesion detection, while intense focal uptake may result in false-positive interpretation of malignancy with PET studies.

Kim et al (3) reviewed the pattern and level of colonic FDG uptake in 300 patients. Intense colonic uptake with a focal pattern was observed more frequently in patients with constipation. These authors suggest that colonic contraction in association with constipation might result in increased muscular activity, which contributes to high FDG uptake. An intraluminal fecal source of FDG was also considered, since FDG was assayed in the stool of these patients. Miraldi et al (5) observed that the FDG accumulation was eliminated after the bowel was cleansed with an iso-osmotic laxative solution and concluded that the colonic FDG localization was intraluminal. However, others have not verified this observation. Jadvar et al (6) examined five patients with FDG PET before and after administration of atropine and sincalide, agents that are known to affect bowel motility. Findings of this study demonstrated that FDG uptake is probably not related to muscular peristalsis. Lymphoid tissue has also been suggested as a possible source of increased FDG uptake by the bowel (7).

Although the mechanism of uptake and the factors that influence it remain unclear, equally uncertain is the relationship between such uptake and the presence of pathologic findings. To explore this phenomenon further and to attempt to elucidate the relationship between colonic FDG uptake and the presence of pathologic findings, we evaluated the pattern and degree of incidental colonic FDG uptake in patients without a known history of colorectal carcinoma who underwent whole-body FDG PET for other purposes and compared them with colonoscopic and/or histopathologic findings.


   MATERIALS AND METHODS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
RESULTS
 DISCUSSION
 REFERENCES
 
Patients
A database of 3,000 patients who were referred to our PET Imaging Sciences Center for imaging studies was searched retrospectively for reports that indicated incidental colonic FDG uptake in patients without known history of colorectal carcinoma or other colonic pathologic findings. The search yielded 80 reports. In the reports, 27 patients (13 men, 14 women; age range, 38–81 years) underwent additional follow-up studies for evaluation of the colon. The reasons for the original referral for PET scanning included staging of lung cancer (n = 9), characterization of indeterminate lung nodules or masses (n = 7), detection of unknown primary tumor (n = 7) , evaluation for inflammatory lung disease versus malignancy (n = 1), evaluation of metastatic disease from esophageal carcinoma (n = 2), and staging of breast cancer (n = 1). Colonoscopy without biopsy was performed in 10 patients, histopathologic analysis of a surgical specimen from a patient who had not undergone colonoscopy was performed in two patients, and colonoscopy with biopsy and histopathologic analysis was performed in 15 patients. All human subjects were studied according to an approved institutional review board protocol with informed consent.

FDG PET Studies
Imaging was performed with a whole-body scanner (ECAT 953; Siemens, Knoxville, Tenn). The scanner parameters included an in-plane and transverse spatial resolution of 6-mm full width half maximum and a 10.5-cm field of view. Patients were instructed to fast overnight before the day of the imaging study. Whole-body PET was performed 45–60 minutes following intravenous administration of 370–555 MBq (10–15 mCi) of FDG. All nonattenuation-corrected images were reconstructed by using a conventional filtered back-projection algorithm and were reviewed in transverse, sagittal, and coronal planes.

Data Analysis
Two readers assigned a grade to the pattern and degree of colonic FDG uptake in consensus, without knowledge of the colonoscopic, histologic, and radiologic findings. The patterns of FDG uptake on the non–attenuation-corrected abdominal images were specified as nodular-focal, nodular-multifocal, segmental, or diffuse. The degree of FDG uptake was assigned a grade according to a four-point scale, similar to that in a previous report (3), as follows: grade 1 for uptake less than background hepatic uptake, grade 2 for uptake similar to that of the liver, grade 3 for uptake moderately greater than hepatic uptake, and grade 4 for intense uptake. The binomial distribution was used to calculate exact one-sided 95% CIs for the probability of finding an abnormality at histologic examination, as predicted by findings at FDG PET (8).


   RESULTS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
RESULTS
DISCUSSION
 REFERENCES
 
Two patients each in whom uptake was assigned grades 1, 2, and 3 had normal colonoscopic findings and a diffuse uptake pattern (Fig 1). In the remaining 21 patients, uptake was assigned a grade of 4. The pattern observed varied as follows: nodular-focal in 11 patients, nodular-multifocal in two patients, segmental in six patients, and diffuse in two patients (Table 1). The nodular-focal pattern was associated with polyps (n = 3), adenoma (n = 3), colon carcinoma (n = 3), colon leiomyosarcoma (n = 1), and metastasis from lung cancer (n = 1). The nodular-multifocal pattern was seen with multiple adenomatous polyps (n = 1) and with bowel and mesenteric metastases from esophageal carcinoma (n = 1). The segmental pattern was seen in a case of colitis (n = 5) and in one case with normal but limited colonoscopic findings caused by suboptimal colonic preparation. Both patients with a diffuse pattern and grade 4 uptake had normal colonoscopic findings (n = 2).



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  		Figure 1a. Coronal PET images of grade 4 diffuse colonic FDG uptake in (a) a 45-year-old woman and (b) a 69-year-old woman, both with normal findings at colonoscopy. The haustral folds (arrowheads) are clearly delineated in b.

 


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  		Figure 1b. Coronal PET images of grade 4 diffuse colonic FDG uptake in (a) a 45-year-old woman and (b) a 69-year-old woman, both with normal findings at colonoscopy. The haustral folds (arrowheads) are clearly delineated in b.

 

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  		TABLE 1. Summary of Observations in Patients with Incidental Colonic FDG Uptake

 
All 13 patients with grade 4 nodular-focal or nodular-multifocal patterns had abnormal correlative colonoscopic and/or histopathologic findings. In seven (54%) of 13 patients, benign neoplasms such as villoglandular adenoma, tubular adenoma, and polyps were present (Fig 2). Moderate to severe dysplasia with additional inflammatory cellularity and hypervascularity was seen at histopathologic analysis in five of the seven patients with these benign neoplasms. In the remaining six (46%) of 13 patients in this category, malignancy was detected. Both the benign and malignant lesions were 1.7 cm in diameter or larger at colonoscopy (Fig 3). Therefore, unsuspected malignancy was detected in six (22%) of the 27 patients in the total study population and was present with only the grade 4 nodular (focal or multifocal) pattern.



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  		Figure 2. Coronal PET image of grade 4 nodular-focal colonic FDG uptake in the hepatic flexure (arrowhead) in a 72-year-old man with a history of lung cancer. At colonoscopy, a 1.7-cm polyp was depicted at this location. Histologic analysis revealed that this polyp was tubulovillous adenoma.

 


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  		Figure 3. Coronal PET image of incidental grade 4 nodular-focal cecal FDG uptake (arrowhead) in a 74-year-old man with an indeterminate lung nodule. At colonoscopy, a 4-cm mass was depicted at this location. Biopsy results revealed primary colon carcinoma.

 
High FDG grade 4 uptake involving a long segment of colon was seen in six patients. In five (83%) of six patients, inflammatory disease was present because of proctitis in one, infectious colitis in one, lymphocytic colitis in one, and hemorrhagic colitis in two patients (Fig 4). In one of six patients in this category, colonoscopic findings were normal despite a high FDG uptake. Therefore, colonic inflammation was seen in five (19%) of the total of 27 patients in the study population and was only associated with a grade 4 segmental pattern. A diffuse pattern, regardless of the grade, was not associated with pathologic findings.



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  		Figure 4a. Coronal PET images show grade 4 segmental colonic FDG uptake (arrowhead) in (a) a 61-year-old man referred for evaluation of an indeterminate lung nodule and (b) a 78-year-old woman referred for restaging of lung cancer. At colonoscopy, hemorrhagic colitis was revealed in the patient in a, and biopsy revealed lymphocytic colitis in the patient in b.

 


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  		Figure 4b. Coronal PET images show grade 4 segmental colonic FDG uptake (arrowhead) in (a) a 61-year-old man referred for evaluation of an indeterminate lung nodule and (b) a 78-year-old woman referred for restaging of lung cancer. At colonoscopy, hemorrhagic colitis was revealed in the patient in a, and biopsy revealed lymphocytic colitis in the patient in b.

 
Quantitative inferences regarding ability to predict the outcome of subsequent histologic examination on the basis of patterns of FDG uptake in the colon can be determined from the data of this study. Results of our analysis are shown in Table 2. Observations in patients with grade 4 focal or multifocal uptake at FDG PET imply (by using an exact one-sided 95% CI) that the probability of abnormality at histologic examination is at least 79%. On the other hand, there is less than a 31% chance that a pattern of diffuse FDG uptake, regardless of grade, indicates a true abnormality. On the basis of our data, the probability of abnormality when FDG PET shows grade 4 segmental uptake is 42% or greater.


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  		TABLE 2. Prediction of Finding an Abnormality on the Basis of Pattern and Grade of Colonic FDG Uptake

 

   DISCUSSION
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
RESULTS
 DISCUSSION
REFERENCES
 
In our experience, the rectosigmoid colon, cecum, and proximal ascending colon display higher levels and a more variable pattern of FDG uptake compared with other colonic regions at visual analysis of PET studies. These observations appear concordant with those of Kim et al (3) and Bischoff-Delaloye and Wahl (4), with the exception of those regarding the rectosigmoid portion of the colon. It remains unclear, however, why certain portions of the colon are more likely to display such high levels of FDG uptake.

Intense colonic FDG uptake has been documented with nonmalignant pathologic processes, such as acute enterocolitis, pseudomembranous colitis, Crohn disease, and ulcerative colitis (9–11). Primary and recurrent colonic malignancies are also well visualized at FDG PET examinations (12). Although to our knowledge there is no published series of data in which the scope of FDG uptake in metastatic disease to the colon is documented, it is highly probable that, on the basis of the known levels of FDG uptake in many forms of cancer, elevated tracer uptake could be expected. In this study, we attempted to demonstrate a relationship between the observation of patterns and degree of colonic FDG uptake and the presence of pathologic findings.

The results at colonoscopy showed dysplastic adenomas or hyperplastic polyps in seven (26%) of 27 patients. All seven patients displayed a grade 4 nodular (focal or multifocal) pattern. Some adenomas, particularly those with a prominent villoglandular component, are considered premalignant lesions (13–15). Therefore, in this setting, FDG PET may be useful in early detection of premalignancies in the colon. In a recent study, observations similar to ours were also reported in that colonic adenomas are hypermetabolic and may be incidentally seen during an FDG PET study (16). Although the exact cause of high FDG uptake in patients with adenomas is unknown, in our study, dysplasia, hypervascularity, and inflammation were observed in most of the patients with these lesions. This finding may have contributed to the high FDG uptake.

PET depicted a malignancy in six (22%) of 27 patients who were not suspected of having a tumor, including three patients with primary colon carcinoma, one patient with colon leiomyosarcoma, and two patients with bowel and mesenteric metastases from esophageal cancer and lung cancer. In all of these patients, high nodular (focal or multifocal) patterns of FDG uptake were displayed. Therefore, of the 13 patients with high nodular-focal and nodular-multifocal uptake patterns, seven had benign neoplasms and six had malignant lesions. Although 19 patients had known cancer at other sites at the time of the PET study, only two of six malignancies discovered in the colon (or two of 13 displaying high nodular-focal or nodular-multifocal uptake) were associated with metastatic disease from the original primary tumor.

Although this latter observation probably was caused by patient selection and was likely influenced by the stage of the cancer at the time of study and the propensity of a particular cancer to be metastatic to the bowel, the data suggest that other forms of malignancy be considered in addition to metastatic disease when this abnormal pattern of uptake is observed on a PET scan. This consideration is important since bowel metastases occur rarely, as in the two cases of primary lung cancer and primary esophageal cancer in our patient group (17–19). In all of these cases, it appears prudent to recommend a follow-up evaluation of the bowel with colonoscopy.

Inflammatory disease was present in five (19%) of 27 patients and was associated with high segmental FDG uptake in five of six patients in whom this pattern was displayed. The remaining patient in this group had normal but limited colonoscopic findings caused by suboptimal colonic cleansing. In the latter patient, it is possible that subclinical inflammation was present but was not depicted at the limited examination. Regardless of this latter patient, since intense segmental uptake appears to be associated with inflammatory disease, a recommendation for follow-up evaluation of the colon with colonoscopy is reasonable, particularly if a diagnosis of coexisting inflammatory bowel disease has an effect on patient treatment. On the other hand, all eight patients with a diffuse uptake pattern involving the entire colon, regardless of grade, had negative findings at colonoscopy. These results suggest, therefore, that a diffuse pattern with varying uptake level is more likely to be representative of a normal physiologic variant rather than of a pathologic process.

We do not typically use attenuation correction for every FDG PET study because this adds considerable time to the procedure and may add little to lesion detection. This idea is similar to the opinion that has been presented by Wahl (20). The patients in our study were referred for a variety of reasons, and therefore, attenuation-corrected images of the abdomen were not obtained systematically for all these patients. Finally, the retrospective search method used to identify patients with incidental colonic activity from a database of more than 3,000 patients most likely caused an underestimation of the frequency of such uptake, since these findings are commonly thought to represent normal variants and may not be mentioned in the scanning report. Additionally, the PET findings regarding colonic uptake may have had a varying influence on the decision to perform follow-up studies. However, the results presented here suggest that the patterns and degree of colonic uptake may be more important than currently recognized. Clinical trials to investigate this issue in larger groups of patients are warranted.

In conclusion, nodular-focal and nodular-multifocal high FDG uptake in the colon are predictive of pathologic findings, which may include malignancy. Colonoscopy is a reasonable next step for further diagnostic evaluation of patients who have these findings. A diffuse colonic FDG uptake pattern, regardless of degree, is predictive of normal findings at colonoscopy, whereas a segmental high uptake may imply an inflammatory condition that warrants follow-up diagnostic studies.


   FOOTNOTES
 
2 Current address: Department of Nuclear Medicine, Sifa Hospital, Izmir, Turkey. Back

Abbreviation: FDG = fluorodeoxyglucose

Author contributions: Guarantors of integrity of entire study, R.T., H.J., P.S.C.; study concepts, R.T., H.J., P.S.C.; study design, R.T., H.J., P.S.C.; literature research, R.T., H.J.; clinical studies, R.T., P.S.C.; data acquisition, R.T.; data analysis/interpretation, all authors; statistical analysis, J.R.B.; manuscript preparation and definition of intellectual content, R.T., H.J., P.S.C.; manuscript editing and revision/review, H.J., P.S.C.; manuscript final version approval, H.J., P.S.C.


   REFERENCES
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
RESULTS
 DISCUSSION
 REFERENCES
 

  1. Engel H, Steinert H, Buck A, Berthold T, Rahel A, von Schulthess GK. Whole-body PET: physiological and artifactual fluorodeoxyglucose accumulations. J Nucl Med 1996; 37:441-446.[Abstract/Free Full Text]
  2. Strauss LG. Fluorine-18 deoxyglucose and false positive results: a major problem in the diagnostics of oncological patients. Eur J Nucl Med 1996; 23:1409-1415.[CrossRef][Medline]
  3. Kim S, Chung JK, Kim BT, et al. Relationship between gastrointestinal F-18-fluorodeoxyglucose accumulation and gastrointestinal symptoms in whole-body PET. Clin Positron Imaging 1999; 2:273-280.[CrossRef][Medline]
  4. Bischoff-Delaloye A, Wahl RL. How high a level of FDG abdominal activity is considered normal (abstr). J Nucl Med 1995; 36:106P.
  5. Miraldi F, Vesselle H, Faulhaber PF, Adler LP, Leisure GP. Elimination of artifactual accumulation of FDG in PET imaging of colorectal cancer. Clin Nucl Med 1998; 23:3-7.[CrossRef][Medline]
  6. Jadvar H, Schambye RB, Segall GM. Effect of atropine and sincalide on the intestinal uptake of F-18 fluorodeoxyglucose. Clin Nucl Med 1999; 24:965-967.[CrossRef][Medline]
  7. Cook GJR, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of 18-fluoro-2-deoxyglucose positron emission tomography scanning: potential for error in interpretation. Semin Nucl Med 1996; 26:308-314.[CrossRef][Medline]
  8. Snedecor GW, Cochran WG. Statistical methods 8th ed. Ames, Iowa: Iowa State University Press, 1989; 110-124.
  9. Meyer MA. Diffusely increased colonic F-18 FDG uptake in acute enterocolitis. Clin Nucl Med 1995; 20:434-435.[Medline]
  10. Hannah A, Scott AM, Akhurst T, Berlangieri S, Bishop J, McKay WJ. Abnormal colonic accumulation of fluorine-18-FDG in pseudomembranous Colitis. J Nucl Med 1996; 37:1683-1685.[Abstract/Free Full Text]
  11. Bicik I, Bauerfeind P, Breitbach T, von Schulthess GK, Fried M. Inflammatory bowel disease activity measured by positron emission tomography (letter). Lancet 1997; 350:262.[Medline]
  12. Conti PS, Lilien DL, Grafton ST, Bading JR, Keppler J, Hawley K. PET and [18F]-FDG: a clinical update. Nucl Med Biol 1996; 23:717-735.[CrossRef][Medline]
  13. Appel MF, Spjut HJ, Estrada RG. The significance of a villous component in colonic polyps. Am J Surg 1977; 134:770-771.[CrossRef][Medline]
  14. Galandiuk S, Fazio VW, Jagelman DG, et al. Villous and tubulovillous adenomas of the colon and rectum: a retrospective review, 1964–1985. Am J Surg 1987; 153:41-47.[CrossRef][Medline]
  15. Sakamoto GD, MacKeigan JM, Senagore AJ. Transanal excision of large, rectal villous adenomas. Dis Colon Rectum 1991; 34:880-885.[CrossRef][Medline]
  16. Yasuda S, Fujii H, Nakahara T, et al. 18F-FDG PET detection of colonic adenomas. J Nucl Med 2001; 42:989-992.[Abstract/Free Full Text]
  17. Antler AS, Ough Y, Pitchumoni CS, Davidian M, Thelmo W. Gastrointestinal metastases from malignant tumors of the lung. Cancer 1982; 49:170-172.[CrossRef][Medline]
  18. Caramella E, Bruneton JN, Roux P, Aubanel D, Lecomte P. Metastases of the digestive tract: report of 77 cases and review of literature. Eur J Radiol 1983; 3:331-338.[Medline]
  19. Carroll D, Rajesh PB. Colonic metastases from primary squamous cell carcinoma of the lung. Eur J Cardiothorac Surg 2001; 19:719-720.[Abstract/Free Full Text]
  20. Wahl RL. To AC or not to AC: that is the question. J Nucl Med 1999; 40:2025-2027.[Free Full Text]



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