Evaluation of PET CT in the Management of Patients With Crohn's Disease.

Evaluation of PET CT in the Management of Patients With Crohn's Disease.

18F-FDG PET/CT (2-[fluorine-18] fluoro-2-deoxy-D-glucose, Positron emission tomography- CT) is a noninvasive technique that allows quantifying and precisely localizing 18F-FDG uptake in the entire body. 18F-FDG uptake is caused by increased local metabolic activity. Such increased uptake has been described not only in neoplastic lesions but also in inflammatory lesions. In this condition, uptake has been correlated with local stimulation of tumor necrosis factor, and with monocyte priming and activation. A physiologic variable uptake may be observed in the bowel, especially the cecum, and has limited the use of PET in inflammatory bowel diseases. The advantage of combined PET and CT devices lead to significant improvements in the interpretation of the bowel areas, and greatly reduces the number of false-positive findings in the gastrointestinal tract.

Inclusion Criteria:

• Patients suspicious for active disease:

  • Patients with suspected but undiagnosed Crohn's disease
  • Patients with serological markers of inflammation (elevated ESR, CRP or thrombocytosis) but clinically in remission
  • Patients with a stricture which might be fibrous in which case surgery is indicated or inflammatory for which medical management is indicated
  • Able to sign a consent form

Exclusion Criteria:

• Pregnancy
• Breastfeeding
• Infectious colitis determined at the initial checkup
• Allergy to iodine contrast