ECR 2013 / B-0557
FDG-avid duodenal lesions: a retrospective analysis of their significance in oncology practice
Keywords:
Small bowel, PET-CT
Authors:
S. Puri, L. Jones, J. Strang; Rochester, NY/US
Conclusion
Conclusions
- Focal or multifocal duodenal FDG uptake is highly predictive of an underlying malignancy with a positive predictive value of 90%
- Diffuse and segmental uptake is commonly related to a nonspecific physiologic process and/or inflammation
- Further studies with larger sample sizes are needed to determine the incidence and significance of various patterns of duodenal FDG uptake in oncology patients referred for PET/CT imaging for evaluation of other unrelated malignancies
Summary
- Small bowel tumors including the duodenum are rare,
accounting for only 1-5% of all GI tumors and often present with an unexplained iron deficiency anemia
- The most frequent primary cancers that metastasize to the duodenum are malignant melanoma,
breast,
lung,
and renal cell carcinoma.
Melanoma metastases tend to be small,
are often multiple involving other areas within the small bowel
- Duodenal lesions are often missed on CECT.
Our review indicates that PET/CT can be an invaluable tool to diagnose and follow patients with duodenal lesions.
- Differential considerations for focal duodenal uptake on FDG- PET/CT include: metastases (most frequently hematogenous),
lymphoma,
adenocarcinoma,
GIST,
carcinoid tumors,
and inflammation.