Work

Clinical significance of incidental focal [18F]-FDG uptake in small bowel on PET-CT

Year: 2025

Type: article

Abstract: OBJECTIVES: There is little evidence to inform investigative pathways for incidental focal uptake of [18F]-FDG in the small bowel on PET-CT, resulting in uncertainty around optimal management in clinical practice. We aimed to assess the proportion of these patients with clinically significant findings on follow-up investigation. METHODS: We conducted a retrospective service evaluation of all [18F]-FDG PET CT examinations (n = 25 050) conducted at our tertiary centre and identified 187 patients with unexpected focal small bowel [18F]-FDG uptake, 68 of which subsequently underwent further investigation to characterize the nature of uptake, including CT/MRI enterography, direct visualization, and repeat PET-CT. We also performed statistical analysis to determine if a SUVMax cutoff could be used to predict the nature of focal uptake (ie, pathological vs. non-pathological). RESULTS: Fourteen out of 68 patients had findings which required further medical treatment or monitoring, 8 (57%) of which were malignant. Only 5 of the 14 patients (35%) had an identifiable abnormality on the low-dose CT component, although pathological lesions were revealed in 7 of the remaining 9 patients following dedicated small bowel investigations. We did not find a significant difference in SUVmax between pathological and physiological uptake. CONCLUSION: Based on our series, up to 1 in 5 patients with incidental small bowel uptake without CT abnormalities may have significant findings requiring treatment. ADVANCES IN KNOWLEDGE: This study supports the recommendation of dedicated cross-sectional small bowel imaging or small bowel endoscopy to investigate incidental small bowel [18F]-FDG uptake, an entity with variable practice in reporting PET-C.

Source: British Journal of Radiology

DOI: 10.1093/bjr/tqaf287

Authors: Jia Zhe Su, Stuart Taylor, Maria Fala, Katie Planche, Thomas Wagner

Institutions: The Royal Free Hospital, University College London

Language: English

Topic: Medical Imaging Techniques and Applications

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,005