The role of 18F-FDG PET/CT in detecting small intestine adenocarcinoma / 中华核医学与分子影像杂志

ABSTRACT

Objective To evaluate the value of whole body 18F-FDG PET/CT in detecting small intestine adenocarcinoma (SIA).Methods A retrospective study of 18F-FDG PET/CT was performed on 29 cases (male 17,female 12) of SIA,21 cases of small intestine lymphoma (SIL) (male 15,female 6) and 10 cases of small intestine tuberculosis (SIT) (male 4,female 6).Visual and semi-quantitative methods (SUVmax) were used to summarize and analyse the 18F-FDG PET/CT resutls.One-way analysis of variance and x2 test were used to analyze the data.Results (1) 18F-FDG PET/CT for SIA showed a partially conglomerate pattern of hypermetabolic small bowel masses with nodular configurations.A typical SIL showed a partially annular abnormal growth with aggregated foci of radioactivity.SIT lesions were usually in form of stripes and/or nodules with high metabolic foci or lesions withskipped distribution.The SUVmax of SIA (8.44±3.82) was significantly lower than that of SIL (11.54±4.02; F=86.96,t=2.77,both P＜0.01),but not significantly different when compared with SIT (8.61±2.99; t=0.11,P＞0.05).(2) The incidence rates of peri-lesion lymph node enlargement in SIA,SIL and SIT were 72.41％ (21/29),85.71％ (18/21) and 70.00％ (7/10),respectively (x2 =1.50,P＞0.05).The SUVmax of peri-lesion lymph nodes in SIA (5.59±2.86) was significantly lower than that of SIL (11.10±5.72; F=56.56,t=3.85,both P＜0.01),but was not significantly different when compared with SIT (5.63± 3.36; t =0.30,P＞ 0.05).The detection rate of PET/CT on pefi-lesion lymph node enlargement of SIA was higher than CT (41.38％,12/29; x2 =5.69,P＜0.05).(3) The incidence rate of extra-intestinal metastases was 55.17％ (16/29) in SIA,and the most common metastatic sites were liver,bone and adrenal gland.The incidence rate of extra-intestinal lesions was 66.67％ (14/21) in SIL,most commonly presented as widespread multifocal nodal permeation.Extra abdominal tuberculous loci were found in 80.00％ (8/10) of SIT.The incidence rates of extra-intestinal involvement were not significantly different among SIA,SIL and SIT (x2=2.13,P＞0.05).(4) Among the 29 SIA cases,15 (51.72％) involved the ileum,8 (27.59％) jejunum,4 (13.79％) both jejunum and ileum,and 2 (6.90％) both jejunum and duodenum (x2 =18.16,P＜0.01).(5) Among the 29 SIA cases,primary SIA was found in 8 cases (27.59％),double primary in 7 cases (24.14％) and metastatic SIA in 14 eases (48.28％).(6) Based on the clinical data,pathological results and clinical follow-up,the diagnosis of SIA by 18F-FDG PET/CT had a sensitivity and specificity of 93.10％ (27/29) and 80.00％ (8/10),respectively.Conclusions 18F-FDG PET/CT is useful for the differential diagnosis of S1A and for supporting the diagnosis of single primary,multi-primary and metastatic SIA.