Keywords:
Small bowel, PET-CT
Authors:
S. Puri, L. Jones, J. Strang; Rochester, NY/US
Results
Results
A total of 8725 PET/CT Scans were performed from January 1,
2009 - July 30,
2012.
Only 94 of 8725 PET/CT reports contained the word duodenum in 83 patients
- 41 Females: age range 20.8-86 years
- 42 Males: Age range 20.5-89.4 years
26 of these 83 patients (28%) had duodenal FDG uptake
52 patients were excluded for the following reasons
- 41 for the word duodenum unassociated with FDG uptake
- 11 extra-duodenal tumors invading the duodenum
4 patients had no FDG uptake (3 lipomas,1 duodenal diverticulum)
1 patient with no FDG uptake was imaged post resection of a duodenal adenocarcinoma
FDG Uptake Pattern of Malignant Duodenal Lesions
Of the 26 patients with duodenal FDG uptake 18 were focal,
1 multifocal,
6 segmental,
and 1 diffuse.
17 of 19 patients with focal or multifocal pattern were malignant (90%)
- 10/17 had known biopsy proven primary or metastatic duodenal malignancy
- 7/17 were newly identified by PET and subsequently proven malignant either by biopsy or response to targeted chemotherapy.
1 known malignant tumor had a segmental pattern of uptake
No malignancy showed diffuse pattern of uptake
Fig. 2
FDG Uptake Pattern of Non-malignant Duodenal Lesions
A total of 8 patients had FDG-avid non-malignant duodenal lesions
2 with focal uptake
- 1 Duodenitis (Biopsy confirmed)
- 1 Nonspecific based on long term follow up and no corresponding duodenal abnormality on other validating imaging studies
5 Segmental Pattern
- 1 Duodenitis based on EGD findings and wall thickness on CECT (known Crohn disease)
- 4 Presumed physiologic based on clinical follow up
1 minimal Diffuse uptake
- Presumed physiologic,
again based on clinical follow up
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