TY - JOUR T1 - Significance of Incidental <sup>18</sup>F-FDG Accumulations in the Gastrointestinal Tract in PET/CT: Correlation with Endoscopic and Histopathologic Results JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1804 LP - 1810 VL - 45 IS - 11 AU - Ehab M. Kamel AU - Miriam Thumshirn AU - Kaspar Truninger AU - Marc Schiesser AU - Michael Fried AU - Barbara Padberg AU - Didier Schneiter AU - Sandro J. Stoeckli AU - Gustav K. von Schulthess AU - Katrin D.M. Stumpe Y1 - 2004/11/01 UR - http://jnm.snmjournals.org/content/45/11/1804.abstract N2 - This study was undertaken to identify the clinical value of incidentally detected lesions (IDLs) in the gastrointestinal tract (GIT) with 18F-FDG PET/CT. Methods: The reported database of 3,281 patients who underwent partial-body 18F-FDG PET/CT scans from April 2001 to September 2003 was reviewed. Patients with incidental 18F-FDG accumulations in the GIT that were associated with concomitant abnormal soft-tissue density or wall thickening on the native CT were evaluated. Incidental PET/CT findings were correlated with endoscopic and histopathologic results. Results: According to our selection criteria, 98 (3%) of the 3,281 patients had an IDL of the GIT on 18F-FDG PET/CT. Correlative endoscopic findings were available in 69 (70%) of 98 patients. Of these, 13 patients (19%) were harboring newly occurring cancers of the GIT in addition to preexisting aerodigestive tract tumors (n = 12) and malignant melanoma (n = 1). Twenty-nine (42%) patients were identified with precancerous lesions, such as advanced colonic adenomas (n = 27), Barrett’s esophagus (n = 1), and intestinal metaplasia of the gastric mucosa (n = 1). Inflammatory and other benign GIT lesions were detected in 12 (17%) and 6 (8%) patients, respectively. In 9 (13%) patients, PET/CT was false-positive, showing normal findings in subsequent endoscopic examinations. In 20 (28%) of 69 patients, PET/CT findings had a relevant impact on the clinical management. Twenty-nine (30%) of the 98 patients were not subject to a further endoscopic examination because of the extent and nature of the primary tumor (n = 17), loss to follow-up (n = 7), death shortly after PET (n = 3), and patient unwillingness (n = 2). Conclusion: Although IDLs of the GIT on 18F-FDG PET/CT scans are found only in about 3% of cases, they are associated with a substantial risk of an underlying cancerous or precancerous lesion. Early identification of these occult lesions may have a major impact on the patients’ management and outcome. ER -