Rajit Aziz, Gilhotra, Lisa, Song, Matthew, Remedios, Eva, Malacova, Mark, Appleyard, Kimberley, Ryan, and Florian, Grimpen
Incidental gastrointestinal tract (GIT) uptake is found in up to 6.3% of patients undergoing positron emission tomography (PET). This may be physiologic or pathologic and requires endoscopic assessment.To determine the diagnostic yield of endoscopy in this setting and characterise PET avidity as a predictor of clinically significant findings.We retrospectively reviewed all consecutive patients undergoing upper endoscopy or colonoscopy for incidentalA total of 255 patients (62% male, median age 67 years) underwent colonoscopy or sigmoidoscopy for 276 separate areas of PET avidity in the colon. Malignancy was found in 44 cases (16%), while a significant polyp was found in an additional 103 cases (37%). Neoplastic change was found more often in case of intense compared with non-intense PET avidity (OR 3.40, 95% CI 1.95-5.93, p0.001), and in focal compared with diffuse uptake (OR 5.97, 95% CI 2.9-12.2, p0.001). Upper GIT endoscopy was performed in 75 patients (46 male, median age 63 years) for 77 isolated areas with PET avidity. Malignancy was found in 16 cases (21%), and all were new primary lesions. Numerically, malignant findings were more common in intense (29.7%) than non-intense (12.5%) PET avidity (OR 2.96, 95%, CI 0.92-9.57, p=0.069).Both focal and intense colonic