TY - JOUR
T1 - Quantifying 18F-Fluorodeoxyglucose Uptake in Perianal Fistulas on PET/CT
T2 - A Retrospective Analysis
AU - Huang, Katherine
AU - Garuba, Favour
AU - Ganapathy, Aravinda
AU - Bishop, Grace
AU - Zhang, Hanjing
AU - Lovato, Adriene
AU - Itani, Malak
AU - Viswanath, Satish E.
AU - Fraum, Tyler J.
AU - Deepak, Parakkal
AU - Ballard, David H.
N1 - Publisher Copyright:
© 2024 The Association of University Radiologists
PY - 2024/7
Y1 - 2024/7
N2 - Rationale and Objectives: The use of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) in assessing inflammatory diseases has shown significant promise. Uptake patterns in perianal fistulas, which may be an incidental finding on PET/CT, have not been purposefully studied. Our aim was to compare FDG uptake of perianal fistulas to that of the liver and anal canal in patients who underwent PET/CT for hematologic/oncologic diagnosis or staging. Materials and Methods: We retrospectively identified patients who underwent FDG-PET/CT imaging between January 2011 and May 2023, where the report described a perianal fistula or abscess. PET/CTs of patients included in the study were retrospectively analyzed to record the maximum standardized uptake value (SUVmax) of the fistula, abscess, anal canal, rectum, and liver. Fistula-to-liver and Fistula-to-anus SUVmax ratios were calculated. We statistically compared FDG activity among the fistula, liver, and anal canal. We also assessed FDG activity in patients with vs. without anorectal cancer, as well as across different St. James fistula grades. Results: The study included 24 patients with identifiable fistulas. Fistula SUVmax (mean = 10.8 ± 5.28) was significantly higher than both the liver (mean = 3.09 ± 0.584, p < 0.0001) and the anal canal (mean = 5.98 ± 2.63, p = 0.0005). Abscess fistula SUVmax was 15.8 ± 4.91. St. James grade 1 fistulas had significantly lower SUVmax compared to grades 2 and 4 (p = 0.0224 and p = 0.0295, respectively). No significant differences existed in SUVmax ratios between anorectal and non-anorectal cancer groups. Conclusion: Perianal fistulas have increased FDG avidity with fistula SUVmax values that are significantly higher than the anal canal.
AB - Rationale and Objectives: The use of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) in assessing inflammatory diseases has shown significant promise. Uptake patterns in perianal fistulas, which may be an incidental finding on PET/CT, have not been purposefully studied. Our aim was to compare FDG uptake of perianal fistulas to that of the liver and anal canal in patients who underwent PET/CT for hematologic/oncologic diagnosis or staging. Materials and Methods: We retrospectively identified patients who underwent FDG-PET/CT imaging between January 2011 and May 2023, where the report described a perianal fistula or abscess. PET/CTs of patients included in the study were retrospectively analyzed to record the maximum standardized uptake value (SUVmax) of the fistula, abscess, anal canal, rectum, and liver. Fistula-to-liver and Fistula-to-anus SUVmax ratios were calculated. We statistically compared FDG activity among the fistula, liver, and anal canal. We also assessed FDG activity in patients with vs. without anorectal cancer, as well as across different St. James fistula grades. Results: The study included 24 patients with identifiable fistulas. Fistula SUVmax (mean = 10.8 ± 5.28) was significantly higher than both the liver (mean = 3.09 ± 0.584, p < 0.0001) and the anal canal (mean = 5.98 ± 2.63, p = 0.0005). Abscess fistula SUVmax was 15.8 ± 4.91. St. James grade 1 fistulas had significantly lower SUVmax compared to grades 2 and 4 (p = 0.0224 and p = 0.0295, respectively). No significant differences existed in SUVmax ratios between anorectal and non-anorectal cancer groups. Conclusion: Perianal fistulas have increased FDG avidity with fistula SUVmax values that are significantly higher than the anal canal.
KW - Crohn's Disease
KW - Inflammation
KW - MRI
KW - PET/CT
KW - Perianal fistula
UR - http://www.scopus.com/inward/record.url?scp=85182429239&partnerID=8YFLogxK
U2 - 10.1016/j.acra.2023.12.020
DO - 10.1016/j.acra.2023.12.020
M3 - Article
C2 - 38177032
AN - SCOPUS:85182429239
SN - 1076-6332
VL - 31
SP - 2775
EP - 2783
JO - Academic radiology
JF - Academic radiology
IS - 7
ER -