Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2024; 12(15): 2466-2474
Published online May 26, 2024. doi: 10.12998/wjcc.v12.i15.2466
Focal incidental colorectal fluorodeoxyglucose uptake: Should it be spotlighted?
Haejun Lee, Kyung-Hoon Hwang
Haejun Lee, Kyung-Hoon Hwang, Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, South Korea
Author contributions: Lee H and Hwang KH designed the editorial, searched the articles, analyzed the data and wrote the manuscript; Lee H contributed analytic tools. All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Kyung-Hoon Hwang, MD, PhD, Professor, Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, No. 21 Namdong-daero 774 beon-gil, Namdong-gu, Incheon 21565, South Korea. forrest88@hanmail.net
Received: December 28, 2023
Revised: March 17, 2024
Accepted: April 12, 2024
Published online: May 26, 2024
Processing time: 138 Days and 1.6 Hours
Abstract

Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) has emerged as a cornerstone in cancer evaluation imaging, with a well-established history spanning several years. This imaging modality, encompassing the examination of the body from the base of the skull to the upper thighs, comprehensively covers the chest and abdominopelvic regions in a singular scan, allowing for a holistic assessment of nearly the entire body, including areas of marginal interest. The inherent advantage of this expansive scan range lies in its potential to unveil unexpected incidental abnormal hypermetabolic areas. The identification of incidental focal FDG uptake within colorectal regions during PET/CT scans is not an uncommon occurrence, albeit fraught with challenges associated with non-specific FDG uptake. The presence of benign colorectal lesions or physiological uptake poses a particular obstacle, as these may manifest with FDG uptake levels that mimic malignancy. Consequently, physicians are confronted with a diagnostic dilemma when encountering abnormal FDG uptake in unexpected colorectal areas. Existing studies have presented divergent results concerning these uptakes. Standardized uptake value and its derivatives have served as pivotal metrics in quantifying FDG uptake in PET images. In this article, we aim to succinctly explore the distinctive characteristics of FDG, delve into imaging findings, and elucidate the clinical significance of incidental focal colorectal uptake. This discussion aims to contribute valuable insights into the nuanced interpretation of such findings, fostering a comprehensive understanding.

Keywords: Focal, Incidental, Colorectal, Fluorodeoxyglucose, Positron emission tomography, Hypermetabolism

Core Tip: The discovery of incidental focal colorectal fluorine-18 fluorodeoxyglucose uptake on positron emission tomography/computed tomography is not uncommon in clinical settings. This phenomenon presents a unique opportunity to delve into its nuanced implications and clinical relevance. In the forthcoming discourse, we aim to explore the intricate details of these unexpected findings, shedding light on the diagnostic challenges they pose and their potential impact on patient outcomes.