IDDF2019-ABS-0038 PET-CT Enterography can help in predicting a clinically significant diagnosis in patients with ileo-cecal thickening

Background Ileo-cecal thickening is a common, nonspecific imaging finding with often uncertain significance. Role of Positron emission tomography with 18F-fluorodeoxyglucose integrated with computed tomographic enterography (FDG-PET-CTE) in patients with ileo-cecal thickening is unclear. Methods Consecutive patients with ileo-cecal thickening on USG from July 2017 to October 2018 underwent FDG-PET-CTE followed by colonoscopy. They were divided in to two groups-those with clinically significant diagnosis (intestinal tuberculosis, Crohn’s disease, infectious colitis, malignancy) and those with clinically insignificant diagnosis (normal colonoscopy or nonspecific terminal ileitis); Standardized uptake value (SUV)-max values from the ileo-cecal area were compared with the final diagnosis and area under the receiver operating characteristic (AUROC) was made to determine the best sensitivity and specificity to predict a clinically significant diagnosis. Results Thirty-four patients were finally included, 23(67.6%) were males and the mean age was 40.44±15.40 years. The clinically significant diagnosis was made in 27(79.4%) patients whereas 7(20.6%) patients had a clinically insignificant diagnosis. Presence of mural thickening on CTE was present in 27 (79.4%) patients. The mean SUVmax for cecum was found to be 5.68±4.09, that for the terminal ileum was 4.19±2.52 and for ileo-cecal valve was 4.62±3.00. The region with the highest SUVmax value was taken for the purpose of comparisons and labelled as SUVmax (ICT). The mean SUVmax (ICT) for patients with clinically significant diagnosis was 7.162±4.382 while those with clinically insignificant diagnosis was 3.629±0.502 (P Conclusions PET-CT enterography could be useful in predicting if ileo-cecal thickening is due to a clinically significant underlying diagnosis and guiding the need of colonoscopy.