Role of PET and combination PET/CT in the evaluation of patients with inflammatory bowel disease

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Abstract

Background:

Positron emission tomography (PET) is a nuclear imaging technique providing noninvasive, three-dimensional, whole-body, quantitative images. The primary use of PET is in tumor detection and staging. More recently, it has been shown to be of value in assessing patients with inflammatory processes. To date the role of PET in the management of patients with inflammatory bowel disease (IBD) has not been defined.

Methods:

The electronic literature (August 1966 to June 2008) on the utilization of PET in IBD was reviewed. Further references were obtained by cross-referencing from key articles.

Results:

There have been no randomized studies to date examining the role of PET in the management of patients with IBD. Comparative studies have demonstrated a high degree of correlation between PET-detected segmental 18F-fluorodeoxyglucose uptake and sites of macroscopic and histological inflammation noted on endoscopy. Prospectively, PET performs favorably in comparison to conventional imaging modalities for IBD such as immunoscintigraphy, magnetic resonance imaging (MRI), and hydro-MRI. Several case series have highlighted the utility of PET in the diagnosis of IBD in the pediatric population. The recent development of PET/computed tomography (CT) combines the physiological sensitivity of PET with the anatomical accuracy of CT, increasing the specificity of PET.

Conclusions:

The case series and nonrandomized studies published to date emphasize the utility of PET in assessing patients with IBD and justify further study. The development of PET/CT represents a significant advance and should be considered in the evaluation of patients with IBD.

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