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CT/PET Combo Might Sub For Colonoscopy

June 2, 2010
Written by: , Filed in: Gastrointestinal Imaging
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Combining CT with PET could provide an effective—and more pleasant—alternative to colonoscopy in detecting polyps and cancer in the colon, according to the results of a new study published in the June issue of The Journal of Nuclear Medicine.

Colorectal cancer affects approximately 6 percent of the population in the Western world and is one of the leading causes of cancer death. Colonoscopy is the standard diagnostic test for colorectal cancer and polyps. But many patients understandably dislike the insertion of the telescopic camera via the rectum, the requirement to empty the bowel by using laxatives beforehand, the possible sedation during the test, and the typical loss of a full day of normal activity.

“One of the first indications of colorectal cancer is often the presence of polyps, which are abnormal tissue growths on the inner lining of the colon, or large intestine,” Stuart A. Taylor, MD, said in a Society of Nuclear Medicine news release. Taylor, of University College London, was lead researcher for the study. “If these polyps are detected noninvasively and without the use of bowel preparation and sedatives, investigation can be much easier on patients who would otherwise undergo colonoscopies.”

Some previous studies of a CT/PET combination have required patients to undergo “complete bowel preparation” (i.e., emptying of the bowel through laxatives) and have included only a small number of patients. The new study is the largest to examine the combination without bowel preparation.

CT colonography (CTC) provides images of the bowel lining after the bowel has been gently distended with gas, without the need for sedatives. PET scanning shows the uptake of glucose (blood sugar) by body tissues. Cancerous cells tend to take up more glucose than normal cells.

For the new study, 56 patients agreed to take a one-hour CTC and PET scan about two weeks before undergoing a colonoscopy. Patients were asked how well they tolerated each test and which they preferred.

The colonoscopies detected polyps in 21 patients, including 14 that were 6 millimeters or greater in size and 8 that were at least 10 mm. The combined CTC/PET scans detected 12 of the 14 polyps that were 6 mm or greater, including all 8 that were at least 10 mm. Not surprisingly, most patients said that the combined scan technique was more comfortable and that they preferred it to colonoscopy.

“The work has shown that combined PET CTC is technically feasible, well tolerated by patients, and capable of achieving high diagnostic accuracy,” Taylor said. “This test would be mainly used in patients less able to tolerate invasive investigations or the preparation required if physicians want to exclude any major pathology in the colon and abdomen.”

Related seminar: National Diagnostic Imaging Symposium


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  1. Radiology – Latest Radiology news – Radiology Medical News about Coronary Angiography on July 30th, 2010 at 7:32 pm

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