Ann Coloproctol.  2018 Apr;34(2):78-82. 10.3393/ac.2017.09.21.

Clinical Etiology of Hypermetabolic Pelvic Lesions in Postoperative Positron Emission Tomography/Computed Tomography for Patients With Rectal and Sigmoid Cancer

• Kang YH
• Han E
• Park G

• KMID: 2411565
• DOI: http://doi.org/10.3393/ac.2017.09.21

Abstract

PURPOSE
The purpose of this study was to present various clinical etiologies of hypermetabolic pelvic lesions on postoperative positron emission tomography/computed tomography (PET/CT) images for patients with rectal and sigmoid cancer.
METHODS
Postoperative PET/CT images for patients with rectal and sigmoid cancer were retrospectively reviewed to identify hypermetabolic pelvic lesions. Positive findings were detected in 70 PET/CT images from 45 patients; 2 patients who were lost to follow-up were excluded. All PET findings were analyzed in comparison with contrast-enhanced CT.
RESULTS
A total of 43 patients were classified into 2 groups: patients with a malignancy including local recurrence (n = 30) and patients with other benign lesions (n = 13). Malignant lesions such as a local recurrent tumor, peritoneal carcinomatosis, and incidental uterine malignancy, as well as various benign lesions such as an anastomotic sinus, fistula, abscess, reactive lymph node, and normal ovary, were observed.
CONCLUSION
PET/CT performed during postoperative surveillance of rectal and sigmoid colon cancer showed increased fluorodeoxyglucose uptake not only in local recurrence, but also in benign pelvic etiologies. Therefore, physicians need to be cautious about the broad clinical spectrum of hypermetabolic pelvic lesions when interpreting images.

Keyword

Colorectal neoplasms; Fluorodeoxyglucose F18; Local neoplasm recurrence; Positron-emission tomography

MeSH Terms

Abscess
Carcinoma
Colon, Sigmoid*
Colorectal Neoplasms
Electrons*
Female
Fistula
Fluorodeoxyglucose F18
Humans
Lost to Follow-Up
Lymph Nodes
Neoplasm Recurrence, Local
Ovary
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography
Recurrence
Retrospective Studies
Sigmoid Neoplasms*
Tomography, X-Ray Computed
Fluorodeoxyglucose F18