İnsidental Fokal Kolorektal FDG PET Tutulumu Olan Hastalarda Kolonoskopi Yapılmalı mı?
Journal Title: Journal of Clinical and Analytical Medicine - Year 2010, Vol 1, Issue 3
Abstract
Aim In this study, we aimed to compare the results colonoscopy and if performed, these of histopathologic examinations in patients which are administered 18fluoro-2-deoxyglucose positron emission tomography (FDG PET) for different reasons and diagnosed incidental colorectal metastasis. Material and Methods 26 cases with established focally increased colorectal activity metastasis and who have been performed FDG PET for various clinical indications are included in the study. Cases are performed colonoscopy for differential diagnosis. Results Age average of the 26 cases included in the study (9 females, 17 males) was 61.9 (38-87). Colonoscopic lesion have been established in 10 cases (38.5 %), while there was none in 16 cases (61.5 % false positive). Number of the cases which endoscopic lesions have been indicated at the localization coherent with activity metastasis in FDG PET was 9 ( 34.6 % ). However in one of the cases, colonoscopic lesion was at a different localization from the one defined in FDG PET examination. Conclusion We have a high false positive ratio in our study. This can be due to FDG shadowing after a poor bowel lavage. For this reason, an adequate bowel lavage administration to the patients before FDG PET examination can reduce the false positive ratio. Thus we can prevent unnecessary invasive attempts. In medical practice, resection of the colonic adenomas found acceptance in protecting from colon cancer. This study showed us that incidental FDG metastasis can indicate premalign or malign lesions. Therefore, colonoscopoic examination is recommended for the cases who have been performed FDG and found increased radioactive metastasis, whether they have been administered bowel lavage or not.
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