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Significance of Incidental ¹⁸F-FDG Accumulations in the Gastrointestinal Tract in PET/CT: Correlation with Endoscopic and Histopathologic Results

¹ Nuclear Medicine, Department of Medical Radiology, University Hospital of Zurich, Zurich, Switzerland
² Gastroenterology, Department of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland
³ Department of Visceral and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland
⁴ Department of Pathology, University Hospital of Zurich, Zurich, Switzerland
⁵ Department of Thoracic Surgery, University Hospital of Zurich, Zurich, Switzerland
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland

View larger version (97K): [in a new window]   FIGURE 1. Maximum-intensity-projection PET (A), transaxial CT (B and D), and transaxial PET/CT (C and E) images from 68-y-old man with known gastric carcinoma and incidentally detected sigmoid carcinoma show pathologic 18F-FDG accumulation in stomach (thick arrows) and sigmoid colon (thin arrows) with correlative mural thickening. (F) Coronally sectioned specimen shows moderately differentiated adenocarcinoma (right half) in highly dysplastic tubulovillous adenoma (left half) (hematoxylin-eosin stain, x20).

View larger version (87K): [in a new window]   FIGURE 2. Coronal PET/CT (A), transaxial CT (B), and transaxial PET/CT (C) images from 69-y-old man show pathologic 18F-FDG accumulation with correlative soft-tissue density (arrows) in right colonic flexure. Endoscopic and histopathologic examinations revealed advanced colonic adenoma.

View larger version (109K): [in a new window]   FIGURE 3. Coronal PET (A), transaxial CT (B), and transaxial PET/CT (C) images from 52-y-old woman with locoregional recurrence of epiglottic carcinoma (thick arrow) and pathologic 18F-FDG accumulation with correlative wall thickening of stomach (thin arrows) consistent with intestinal metaplasia of gastric mucosa.

View larger version (81K): [in a new window]   FIGURE 4. Coronal PET/CT (A), transaxial CT (B), and transaxial PET/CT (C) images from 42-y-old woman after recent intake of ciprofloxacin show segmental 18F-FDG accumulation in ascending colon with correlative circumscribed mural thickening (arrows). Pseudomembranous colitis was confirmed after cultivating Clostridium difficile in stool probes.