Hybrid 18F-FDG PET/CT of colonic anastomosis

P. H. E. Teeuwen; L. F. de Geus-Oei; T. Hendriks; H. van Goor; A. J. A. Bremers; W. J. G. Oyen; R. P. Bleichrodt

doi:10.3413/Nukmed-0493-12-04

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2012; 51(06): 252-256
DOI: 10.3413/Nukmed-0493-12-04

Original article

Schattauer GmbH

Hybrid ¹⁸F-FDG PET/CT of colonic anastomosis

A possibility to detect anastomotic leakage?Hybrid ¹⁸F-FDG PET/CT kolorektaler AnastomosenEin Verfahren zur Entdeckung eines anastomotisches Darmlecks?

Authors

P. H. E. Teeuwen

¹Department of Surgery, Division of abdominal surgery and surgical oncology, Medical Centre, Radboud University Nijmegen
L. F. de Geus-Oei

²Department of Nuclear Medicine, Medical Centre, Radboud University Nijmegen, The Netherlands
T. Hendriks

¹Department of Surgery, Division of abdominal surgery and surgical oncology, Medical Centre, Radboud University Nijmegen
H. van Goor

¹Department of Surgery, Division of abdominal surgery and surgical oncology, Medical Centre, Radboud University Nijmegen
A. J. A. Bremers

¹Department of Surgery, Division of abdominal surgery and surgical oncology, Medical Centre, Radboud University Nijmegen
W. J. G. Oyen

²Department of Nuclear Medicine, Medical Centre, Radboud University Nijmegen, The Netherlands
R. P. Bleichrodt

¹Department of Surgery, Division of abdominal surgery and surgical oncology, Medical Centre, Radboud University Nijmegen

Abstract

Summary

¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a known method to diagnose inflammatory processes and thus may be a promising imaging technique to detect anastomotic bowel leak. The aim of this study was to assess postoperative FDG uptake in colorectal anastomosis in patients without suspicion of active infection or anastomotic leakage. Patients, methods: Design of a prospective observational pilot study in order to assess normal FDG uptake in the patient anastomosis after colorectal surgery. Patients that underwent colorectal surgery with primary anastomosis received FDG-PET of the abdomen, 2–6 days postoperatively. Results: 35 patients met the inclusion criteria. Three patients were not scanned for various reasons. Of the remaining 32 patients, one demonstrated an increased uptake of FDG at the site of the anastomosis. In the other 31 patients FDG uptake was negligible (n = 17) or scored as physiological (n = 14). None of the scanned patients developed a clinical relevant anastomotic leakage within the first 30 days after surgery. Conclusion: The present study shows that FDG uptake in colorectal anastomosis remains low within the first six days after surgery in patients without anastomotic leakage. Therefore, FDG-PET might be useful to investigate further as a tool to detect anastomotic leakage in an the early postoperative phase.

Zusammenfassung

Hintergrund: ¹⁸F-Fluordeoxyglukose-Positronenemissionstomographie (FDG-PET) ist ein bekanntes Verfahren zur Diagnose entzündlicher Prozesse und somit ein viel versprechen des bildgebendes Verfahren, um ein anastomotisches Darmleck zu erfassen. Ziel dieser Studie war, die postoperative FDG-Aufnahme in kolorektalen Anastomosen bei Patienten ohne Verdacht auf Infektion oder Anastomoseninsuffizienz zu beurteilen. Patienten, Methoden: Design einer Pilotstudie zur Beurteilung der normalen FDG-Aufnahme in Anastomosen nach kolorektaler Chirurgie. Patienten, die sich kolorektaler Chirurgie mit primärer Anastomose unterzogen, erhielten FDG-PET des Bauches, 2–6 Tage nach der Operation. Ergebnisse: 35 Patienten erfüllten die Einschlusskriterien, 3 Patienten wurden aus verschiedenen Gründen nicht gescannt. Von den verbleibenden 32 Patienten zeigte ein Patient eine erhöhte FDG-Aufnahme im Bereich der Anastomose. Bei den anderen 31 Patienten war die FDG-Aufnahme zu vernachlässigen (n = 17) oder als physiologisch anzusehen (n = 14). Kein Patient entwickelte eine klinisch relevante Anastomoseninsuffizienz in den ersten 30 Tagen nach der Operation. Schlussfolgerung: Die Ergebnisse dieser Studie zeigen, dass die FDG-Aufnahme in kolorektalen Anastomosen niedrig bleibt innerhalb der ersten sechs Tage nach der Operation bei Patienten ohne Anastomoseninsuffizienz. Daher könnte die FDG-PET nützlich sein, um weiter zu untersuchen, ob sie als Instrument zur Erfassung einer Anastomoseninsuffizienz im frühen Stadium der postoperativen Phase geeignet ist.

Keywords

PET/CT - colorectal surgery - anastomotic leakage

Schlüsselwörter

PET/CT - kolorektale Chirurgie - Anastomosen insuffizienz

Full Text

References

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