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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 10/2020

Open Access 30.06.2020 | Letter To The Editor & Reply

Reply to Letter to the Editor: “The added benefit of contrast-enhanced CT in the evaluation of incidental FDG-avid colon lesions”

verfasst von: Julian Kirchner, Benedikt M. Schaarschmidt, Firas Kour, Lino M. Sawicki, Ole Martin, Johannes Bode, Stephan vom Dahl, Verena Keitel, Dieter Häussinger, Christina Antke, Christian Buchbender, Gerald Antoch, Philipp Heusch

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 10/2020

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This article is part of the Topical Collection on Oncology Digestive tract
This Letter to the editor and reply refers to the article https://​doi.​org/​10.​1007/​s00259-020-04716-y

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
We would like to thank Dr. Lee and colleagues for their well-thought-out questions and their interest in our work about the added benefit of contrast-enhanced CT in the evaluation of incidental FDG-avid colonic lesions [1].
First, while an overall incidence of focal 18F-FDG uptake in the colon has been observed in 1.3–3% [27] in the studies mentioned by Dr. Lee and colleagues, focal tracer uptake was detected in 38.4% in our cohort. Taking a closer look at the results, this difference is probably due to a different reference standard. All studies mentioned by Dr. Lee and colleagues calculated the incidence based on the total sum of all PET/CT examinations performed. Our study only included patients who had undergone contrast-enhanced 18F-FDG PET/CT and colonoscopy within 6 months after PET/CT. Compared with a non-selected patient population, the population in our study can, thus, be expected to have a higher incidence of colon pathology. This issue has been addressed in Discussion. Assessment for focal colonic 18F-FDG uptake was performed based on only the PET dataset; thus, the CT component had no influence on the incidence.
Second, in our study, the positive predictive value (PPV) was increased from 29 to 50% by including CT findings (wall-thickening, intraluminal nodule, and contrast enhancement). To our opinion, similar PPVs in the studies cited by Dr. Lee and colleagues may also be explained by difference in patient populations. In the study by Gutman et al., the PPV was 67%, but was calculated for all coloscopic abnormalities and included adenomas with mild to moderate dysplasia [4]. In the study by Lee et al., every type of adenoma was defined as pre-malignant [7], while in our study, adenomas without or with low-grade intraepithelial neoplasias were excluded, as they do not have clinical impact. The PPV given in the study of Israel et al. (46%) was calculated for the whole GIT; results for findings only in the colon are not given in this paper [5]. The highest PPV was reported by Even-Sapir et al. However, this study design aimed at the evaluation of malignant colonic tumours and pre-malignant lesions rather than all incidentally found lesions [3]. Only proven malignancies were included in the final analysis and even FDG-PET-negative masses detected on CT.

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Not applicable.

Ethical approval

Institutional Review Board approval does not apply because the paper is an Editorial.

Conflict of interest

The authors declare that they have no conflict of interest.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.

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Literatur
1.
Zurück zum Zitat Kirchner J, Schaarschmidt BM, Kour F, et al. Incidental (18)F-FDG uptake in the colon: value of contrast-enhanced CT correlation with colonoscopic findings. Eur J Nucl Med Mol Imaging. 2019. Kirchner J, Schaarschmidt BM, Kour F, et al. Incidental (18)F-FDG uptake in the colon: value of contrast-enhanced CT correlation with colonoscopic findings. Eur J Nucl Med Mol Imaging. 2019.
2.
Zurück zum Zitat Agress H Jr, Cooper BZ. Detection of clinically unexpected malignant and premalignant tumors with whole-body FDG PET: histopathologic comparison. Radiology. 2004;230(2):417–22.CrossRef Agress H Jr, Cooper BZ. Detection of clinically unexpected malignant and premalignant tumors with whole-body FDG PET: histopathologic comparison. Radiology. 2004;230(2):417–22.CrossRef
3.
Zurück zum Zitat Even-Sapir E, Lerman H, Gutman M, et al. The presentation of malignant tumours and pre-malignant lesions incidentally found on PET-CT. Eur J Nucl Med Mol Imaging. 2006;33(5):541–52.CrossRef Even-Sapir E, Lerman H, Gutman M, et al. The presentation of malignant tumours and pre-malignant lesions incidentally found on PET-CT. Eur J Nucl Med Mol Imaging. 2006;33(5):541–52.CrossRef
4.
Zurück zum Zitat Gutman F, Alberini JL, Wartski M, et al. Incidental colonic focal lesions detected by FDG PET/CT. AJR Am J Roentgenol. 2005;185(2):495–500.CrossRef Gutman F, Alberini JL, Wartski M, et al. Incidental colonic focal lesions detected by FDG PET/CT. AJR Am J Roentgenol. 2005;185(2):495–500.CrossRef
5.
Zurück zum Zitat Israel O, Yefremov N, Bar-Shalom R, et al. PET/CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence, localization patterns, and clinical significance. J Nucl Med. 2005;46(5):758–62.PubMed Israel O, Yefremov N, Bar-Shalom R, et al. PET/CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence, localization patterns, and clinical significance. J Nucl Med. 2005;46(5):758–62.PubMed
6.
Zurück zum Zitat Kamel EM, Thumshirn M, Truninger K, et al. Significance of incidental 18F-FDG accumulations in the gastrointestinal tract in PET/CT: correlation with endoscopic and histopathologic results. J Nucl Med. 2004;45(11):1804–10.PubMed Kamel EM, Thumshirn M, Truninger K, et al. Significance of incidental 18F-FDG accumulations in the gastrointestinal tract in PET/CT: correlation with endoscopic and histopathologic results. J Nucl Med. 2004;45(11):1804–10.PubMed
7.
Zurück zum Zitat Lee JC, Hartnett GF, Hughes BG, Ravi Kumar AS. The segmental distribution and clinical significance of colorectal fluorodeoxyglucose uptake incidentally detected on PET-CT. Nucl Med Commun. 2009;30(5):333–7.CrossRef Lee JC, Hartnett GF, Hughes BG, Ravi Kumar AS. The segmental distribution and clinical significance of colorectal fluorodeoxyglucose uptake incidentally detected on PET-CT. Nucl Med Commun. 2009;30(5):333–7.CrossRef
Metadaten
Titel
Reply to Letter to the Editor: “The added benefit of contrast-enhanced CT in the evaluation of incidental FDG-avid colon lesions”
verfasst von
Julian Kirchner
Benedikt M. Schaarschmidt
Firas Kour
Lino M. Sawicki
Ole Martin
Johannes Bode
Stephan vom Dahl
Verena Keitel
Dieter Häussinger
Christina Antke
Christian Buchbender
Gerald Antoch
Philipp Heusch
Publikationsdatum
30.06.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 10/2020
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-020-04749-3

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