Value of 18F-FDG PET/CT in the Diagnosis and Grading of Incidental Colorectal Adenomas

Abstract

PurposeColorectal adenomas (CRAs) are at a higher risk of progressing to colorectal cancer (CRC) as their histological grade increases. Herein, this study investigated the relationship between the maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) and the histological grades of CRAs and constructed the optimal regression model for distinguishing between different histological grades. MethodsThis study retrospectively analyzed the data of 153 patients with CRAs who had colorectal 18F-FDG uptake incidentally found on PET/CT. The patients were categorized into low-grade intraepithelial neoplasia (LGIN) and high-grade intraepithelial neoplasia (HGIN) groups based on their histological grade. After the analysis of the relationship between SUVmax measured on preoperative 18F-FDG PET/CT scans and histological grades, receiver-operating characteristic (ROC) curves were analyzed to determine the optimal cut-off values for distinguishing between the two groups. Common clinical and pathological factors were included and subjected to univariate and multivariate logistic regression analyses to identify independent risk factors. A diagnostic model integrating SUVmax and several risk factors was developed with the multivariate logistic regression analysis. ResultsSUVmax was significantly different between the two groups (P < 0.001) and increased with an elevation in the malignancy degree. The area under the ROC curve (AUC) for identifying LGIN and HGIN was 0.796, and the AUC of the combination model was 0.822. Furthermore, SUVmax was an independent risk factor for distinguishing between different histological grades in pairwise comparisons. ConclusionThe regression model involving SUVmax on 18F-FDG PET/CT can distinguish between histological grades of CRAs, which therefore can be used as a noninvasive tool for the accurate diagnosis of CRAs and assist in developing patient-specific treatment strategies before surgery.