Positron emission tomography (PET) used to image subclinical inflammation associated with ulcerative colitis (UC) in remission

Inflammatory bowel diseases (IBD) are a group of pathological conditions characterized by chronic inflammation of the gastrointestinal tract, including Crohn's disease and ulcerative colitis. To date, imaging of IBD is based on several radiological techniques such as barium studies, magnetic resonance imaging, and computed tomography (CT). Endoscopy is the gold standard for the assessment of the large bowel and proximal small intestine in patients with IBD allowing the biopsy of the visualized bowel. Positron emission tomography (PET) and PET/CT with Fluorine-18-fluoro-2-deoxy-D-glucose (FDG) is a functional imaging method used to detect abnormalities in glucose metabolism in a variety of disorders. FDG accumulates mainly in tumours, but increased uptake and retention has been shown also in lesions with a high concentration of inflammatory cells, such as granulocytes and activated macrophages. Recent literature data demonstrate that FDG-PET and PET/CT may be useful noninvasive tools for identifying and localizing active IBD. In patients with an established diagnosis of IBD, FDG-PET and PET/CT may provide information about disease activity, location and extent of the disease within the intestinal tract, allowing early recognition of disease relapse and possible complications. Furthermore, these techniques may play a role in assessing the treatment response to medical therapy in patients with IBD.

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“…In particular, FDG-PET demonstrated inflammatory activity in the colon despite negative endoscopic, histologic, and symptom assessment (16).…”

Section: Fdg-pet and Petict In The Assessment Ofibd In Adult Patientsmentioning

confidence: 96%

The Role of Positron Emission Tomography in Inflammatory Bowel Disease

et al. 2012

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“…The PET/CT response correlated with improvement in physician global assessment scores [52]. Rubin et al studied the utility of FDG uptake in a cohort of 10 patients with well-characterized UC in endoscopic remission, utilizing PET/CT scans performed a mean of 37 days after a colonoscopy [53]. Three patients had elevated FDG uptake in the colon despite clinical remission and one patient with increased uptake in the terminal ileum was later found to have Crohn’s ileocolitis.…”

Section: Nuclear Medicine Imagingmentioning

confidence: 99%

Radiographical evaluation of ulcerative colitis

Deepak

2014

Gastroenterology Report

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Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis (UC). Imaging can be used non-invasively to determine the extent of involvement, severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease (IBD) manifestations. While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings, the use of computed tomography enterography (CTE) or magnetic resonance enterography (MRE) are now used as first-line investigations to exclude active small bowel disease in IBD patients and can be utilized to detect active colonic inflammation. Additionally, CT colonography and MR colonography are emerging techniques with potential applications in UC. Ultrasonography, leukocyte scintigraphy and positron emission tomography are novel abdominal imaging modalities currently being explored for IBD interrogations. This plethora of radiological imaging options has become a vital component of UC assessments.

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“…FDG uptake may also be identified in associated inflammatory lesions, such as perianal fistulas, cholangitis, and sacroiliitis. Increased FDG uptake may occasionally be observed in segments of bowel known to be involved by Crohn's disease, but during apparent clinical remission and in the absence of symptoms [27,50]. Whether or not such metabolic activity reflects chronic inflammation smoldering between active flares of disease and whether or not this finding may predict a shorter time interval to relapse remain to be determined (Fig.…”

Section: Pet and Pet/ct Interpretation Considerationsmentioning

confidence: 99%

18F-FDG positron emission tomography: potential utility in the assessment of Crohn’s disease

Shyn

2011

Abdom Imaging

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Computed Tomography Enterography (CTE) and Magnetic Resonance Enterography (MRE) are currently the dominant imaging tests used in the assessment of patients with Crohn's disease. More recently, the possibility of utilizing F-18 fluorodeoxyglucose (18F-FDG) Positron Emission Tomography (PET) or PET/CT has been explored in several preliminary studies. 18F-FDG PET appears to enable reliable detection of moderate to severe inflammation in bowel segments involved by Crohn's disease. Perhaps more importantly, 18F-FDG PET has the potential to provide a noninvasive, quantitative measure of inflammation that dynamically reflects changes in Crohn's disease activity. If 18F-FDG PET proves useful in monitoring responses to medical therapy within a few days of therapy initiation, an important new role for imaging in the management of patients with Crohn's disease could emerge.

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Positron emission tomography (PET) used to image subclinical inflammation associated with ulcerative colitis (UC) in remission

Abstract: In this study, PET demonstrated inflammatory activity in the colon despite negative endoscopic, histologic, and symptom assessment. This has important implications in the understanding of UC disease quiescence. Further exploration of this highly sensitive modality should be performed.

Cited by 32 publications

References 11 publications

The Role of Positron Emission Tomography in Inflammatory Bowel Disease

The Role of Positron Emission Tomography in Inflammatory Bowel Disease

Radiographical evaluation of ulcerative colitis

18F-FDG positron emission tomography: potential utility in the assessment of Crohn’s disease

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