Incidental anal 18fluorodeoxyglucose uptake: Should we further examine the patient?

doi:10.12998/wjcc.v8.i17.3679

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World Journal of Clinical Cases

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Retrospective Study

World J Clin Cases. Sep 6, 2020; 8(17): 3679-3690
Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3679

Incidental anal ¹⁸fluorodeoxyglucose uptake: Should we further examine the patient?

Anne-Sophie Moussaddaq, Charlène Brochard, Xavier Palard-Novello, Etienne Garin, Timothée Wallenhorst, Eric Le Balc’h, Alexandre Merlini L’heritier, Thomas Grainville, Laurent Siproudhis, Astrid Lièvre

Anne-Sophie Moussaddaq, Charlène Brochard, Timothée Wallenhorst, Eric Le Balc’h, Alexandre Merlini L’heritier, Thomas Grainville, Laurent Siproudhis, Astrid Lièvre, Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, Rennes 35000, France

Charlène Brochard, Laurent Siproudhis, Inphy CIC 1414 University Hospital of Rennes, Pontchaillou, Rennes 35000, France

Xavier Palard-Novello, Etienne Garin, Department of Nuclear Medicine, Cancer Institute Eugène Marquis, Rennes 35000, France

Etienne Garin, Laboratoire Traitement du Signal et de l'Image-UMR1099, University of Rennes, Inserm, Rennes 35000, France

Author contributions: Moussaddaq AS, Brochard C and Lièvre AM designed research; Moussaddaq AS, Brochard C, Palard-Novello X, Garin E, Wallenhorst, T, Le Balch E, Merlini L’Héritier A, Grainville T and Siproudhis L performed research; Moussaddaq AS, Brochard C, Palard-Novello X and Siproudhis L contributed analytic tools; Moussaddaq AS, Brochard C and Lièvre A analyzed data; Moussaddaq AS, Brochard C and Lièvre A wrote the paper.

Institutional review board statement: This study was reviewed and approved by the Hospital Ethics Committee of Rennes (n° 19.38) on April 4, 2019.

Informed consent statement: Patients were informed and did not express their opposition to participate in the study.

Conflict-of-interest statement: Charlène Brochard received lecture fees from Ipsen. Laurent Siproudhis received lecture fees from Abbvie, Ferring and MSD. Laurent Siproudhis received consultant fees from Takeda and Ferring. Others have no conflicts of interest.

Data sharing statement: Not applicable.

Corresponding author: Charlène Brochard, MD, PhD, Doctor, Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, 2 rue Henri Le Guillou, Rennes 35000, France. charlene.brochard@chu-rennes.fr

Received: January 3, 2020
Peer-review started: January 3, 2020
First decision: January 18, 2020
Revised: May 15, 2020
Accepted: August 1, 2020
Article in press: August 1, 2020
Published online: September 6, 2020
Processing time: 244 Days and 14.9 Hours

Abstract

BACKGROUND

There are no studies on incidental anal ¹⁸F-fluorodeoxyglucose (¹⁸FDG) uptake.

AIM

To assess the rate and aetiologies of incidental anal ¹⁸FDG uptake and to evaluate the correlation between ¹⁸FDG positron-emission tomography/computed tomography (PET/CT) parameters and the diagnosis of an anorectal disease.

METHODS

The data from patients with incidental anal ¹⁸FDG uptake were retrospectively analysed. Patients who underwent anorectal examinations were identified and compared to those who did not undergo examinations. Patients who were offered treatment were then identified and compared to those who did not receive treatment.

RESULTS

Among the 43020 ¹⁸FDG PET/CT scans performed, 197 ¹⁸FDG PET/CT scans of 146 patients (0.45%) reported incidental anal uptake. Among the 134 patients included, 48 (35.8%) patients underwent anorectal examinations, and anorectal diseases were diagnosed in 33 (69.0%) of these patients and treated in 18/48 (37.5%) patients. Among the examined patients, those with a pathology requiring treatment had significantly smaller metabolic volumes (MV) 30 and MV41 values and higher maximal and mean standardized uptake value measurements than those who did not require treatment.

CONCLUSION

Incidental anal ¹⁸FDG uptake is rare, but a reliable anorectal diagnosis is commonly obtained when an anorectal examination is performed. The diagnosis of an anorectal disease induces treatment in more than one-third of the patients. These data should encourage practitioners to explore incidental anal ¹⁸FDG uptake systematically.

Keywords: Incidental anal ¹⁸fluorodeoxyglucose uptake; Anorectal disease; Rare

Core tip: This is a retrospective study to assess the rate and aetiologies of incidental anal ¹⁸F-fluorodeoxyglucose (¹⁸FDG) uptake and to evaluate the correlation between ¹⁸FDG positron-emission tomography/computed tomography parameters and the diagnosis of an anorectal disease. Incidental anal ¹⁸FDG uptake is rare, but a reliable anorectal diagnosis is commonly obtained when an anorectal examination is performed. The diagnosis of an anorectal disease induces treatment in more than one-third of the patients. These data should encourage practitioners to explore incidental anal ¹⁸FDG uptake systematically.