Positron emission tomography for the detection of colorectal adenomas

Background: 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) has been reported to detect colorectal adenomas. Aims: This study aimed at evaluating the sensitivity of 18F-FDG PET with computed tomography image fusion (PET/CT) for detecting colorectal adenomas. Methods: We retrospectively compared the results of 92 18F-FDG PET/CT studies followed by colonoscopy. Colonoscopy and histology were considered as the gold standard. Results: One hundred fifty-seven lesions were observed. All the 12 malignancies were identified by 18F-FDG PET/CT but only 27 out of 119 resected adenomas (sensitivity 22.7%) and none of the hyperplastic polyps were detected. At the univariate and multivariate analyses there was a significant statistical association between adenomas sized more than 10 mm, presence of villous component and high-grade dysplasia and the ability of 18F-FDG PET/CT to detect adenomas. 18F-FDG PET/CT showed an overall sensitivity of 29.8%, a specificity of 81.1%, a positive predictive value (PPV) of 84.8% and a negative predictive value (NPV) of 24.6% for the neoplastic colorectal lesions globally considered. Conclusion: 18F-FDG PET/CT has a low sensitivity for detecting adenomas. However, because of the specificity and PPV of the technique for neoplastic colorectal lesions, the presence of a focal colorectal FDG uptake justifies the patient undergoing colonoscopy. © 2009 Editrice Gastroenterologica Italiana S.r.l

Coronavirus disease 2019 in patients with neuroendocrine neoplasms:Preliminary results of the INTENSIVE study

BACKGROUND: Specific data regarding COVID-19 in patients with neuroendocrine neoplasms (NEN) are lacking. This aim of this study is to describe the characteristics of NEN patients who tested SARS-CoV-2 positive. MATERIAL AND METHODS: This is a worldwide study collecting cases of NEN patients with a positive nasopharyngeal swab RT-PCR for SARS-CoV-2 between June 1, 2020, and March 31, 2021. Centers treating NEN patients were directly contacted by the principal investigator. Patients with NEN of any primary site, grade, and stage were included, excluding small-cell lung carcinoma and mixed adeno-neuroendocrine carcinoma. RESULTS: Among 81 centers directly contacted 88.8% responded and 48.6% of them declined due to lack of cases or interest. On March 31(st), 2021, eight recruiting centers enrolled 89 patients. Median age was 64 years at the COVID-19 diagnosis. Most patients had metastatic, non-functioning, low/intermediate grade gastro-entero-pancreatic (GEP) NEN, on treatment with somatostatin analogs (SSA) and radioligand therapy (RLT). Most of them had comorbidities. Only 8% of patients had high grade NEN and 12% were receiving chemotherapy. Most patients had symptoms or signs of COVID-19, mainly fever and cough. Only 3 patients underwent sub-intensive treatment, whereas the majority received medical therapies, mostly antibiotics. In two third of cases, no changes occurred for the anti-NEN therapy. More than 80% of patients completely recovered without sequelae whereas 7.8% patients died due to COVID-19. CONCLUSIONS: Patients included in this study reflect the typical NEN population regardless of SARS-CoV-2. In the majority of cases they overcome COVID-19 without need of intensive care, short-term sequelae and discontinuation of systemic oncological therapy

Coronavirus disease 2019 in patients with neuroendocrine neoplasms: Preliminary results of the INTENSIVE study

Background: Specific data regarding coronavirus disease 2019 (COVID-19) in pa-tients with neuroendocrine neoplasms (NENs) are lacking. The aim of this study is to describe the characteristics of patients with NENs who tested severe acute respiratory syndrome cor-onavirus 2 (SARS-CoV-2) positive. Material and methods: This is a worldwide study collecting cases of patients with NENs along with a positive nasopharyngeal swab reverse transcriptase-polymerase chain reaction (RT-PCR) test for SARS-CoV-2 between June 1, 2020, and March 31, 2021. Centres treating pa-tients with NENs were directly contacted by the principal investigator. Patients with NENs of any primary site, grade and stage were included, excluding small-cell lung carcinoma and mixed adenoneuroendocrine carcinoma. Results: Among 81 centres directly contacted, 88.8% responded and 48.6% of them declined due to lack of cases or interest. On March 31st, 2021, eight recruiting centres enrolled 89 pa-tients. The median age was 64 years at the time of COVID-19 diagnosis. Most patients had metastatic, non-functioning, low-/intermediate-grade gastroenteropancreatic NENs on treat-ment with somatostatin analogues and radioligand therapy. Most of them had comorbidities. Only 8% of patients had high-grade NENs and 12% were receiving chemotherapy. Most pa-tients had symptoms or signs of COVID-19, mainly fever and cough. Only 3 patients under-went sub-intensive treatment, whereas most of them received medical therapies, mostly antibiotics. In two third of cases, no changes occurred for the anti-NEN therapy. More than 80% of patients completely recovered without sequelae, whereas 7.8% patients died due to COVID-19. Conclusions: Patients included in this study reflect the typical NEN population regardless of SARS-CoV-2. In most cases, they overcome COVID-19 without need of intensive care, short-term sequelae and discontinuation of systemic oncological therapy. (C) 2021 Elsevier Ltd. All rights reserved

COVID-19 in patients with neuroendocrine neoplasms:2-year results of the INTENSIVE study

We conducted a retrospective/prospective worldwide study on patients with neuroendocrine neoplasms (NENs) and a molecularly proven SARS-CoV-2 positivity. Preliminary results regarding 85 patients of the INTENSIVE study have been published in 2021. Now we are reporting the 2-year analysis. Here, we are reporting data from consecutive patients enrolled between 1 June 2020, and 31 May 2022. Among the 118 contacted centers, 25 were active to enroll and 19 actively recruiting at the time of data cut-off for a total of 280 patients enrolled. SARS-CoV-2 positivity occurred in 47.5% of patients in 2020, 35.1% in 2021, and 17.4% in 2022. The median age for COVID-19 diagnosis was 60 years. Well-differentiated tumors, non-functioning, metastatic stage, and gastroenteropancreatic (GEP) primary sites represented most of the NENs. COVID-19-related pneumonia occurred in 22.8% of the total, with 61.3% of them requiring hospitalization; 11 patients (3.9%) needed sub-intensive or intensive care unit therapies and 14 patients died (5%), in 11 cases (3.9%) directly related to COVID-19. Diabetes mellitus and age at COVID-19 diagnosis &gt; 70 years were significantly associated with COVID-19 mortality, whereas thoracic primary site with COVID-19 morbidity. A significant decrease in both hospitalization and pneumonia occurred in 2022 vs 2020. In our largest series of NEN patients with COVID-19, the NEN population is similar to the general population of patients with NEN regardless of COVID-19. However, older age, non-GEP primary sites and diabetes mellitus should be carefully considered for increased COVID-19 morbidity and mortality. Relevant information could be derived by integrating our results with NENs patients included in other cancer patients with COVID-19 registries.</p

COVID-19 in patients with neuroendocrine neoplasms:2-year results of the INTENSIVE study

We conducted a retrospective/prospective worldwide study on patients with neuroendocrine neoplasms (NENs) and a molecularly proven SARS-CoV-2 positivity. Preliminary results regarding 85 patients of the INTENSIVE study have been published in 2021. Now we are reporting the 2-year analysis. Here, we are reporting data from consecutive patients enrolled between 1 June 2020, and 31 May 2022. Among the 118 contacted centers, 25 were active to enroll and 19 actively recruiting at the time of data cut-off for a total of 280 patients enrolled. SARS-CoV-2 positivity occurred in 47.5% of patients in 2020, 35.1% in 2021, and 17.4% in 2022. The median age for COVID-19 diagnosis was 60 years. Well-differentiated tumors, non-functioning, metastatic stage, and gastroenteropancreatic (GEP) primary sites represented most of the NENs. COVID-19-related pneumonia occurred in 22.8% of the total, with 61.3% of them requiring hospitalization; 11 patients (3.9%) needed sub-intensive or intensive care unit therapies and 14 patients died (5%), in 11 cases (3.9%) directly related to COVID-19. Diabetes mellitus and age at COVID-19 diagnosis &gt; 70 years were significantly associated with COVID-19 mortality, whereas thoracic primary site with COVID-19 morbidity. A significant decrease in both hospitalization and pneumonia occurred in 2022 vs 2020. In our largest series of NEN patients with COVID-19, the NEN population is similar to the general population of patients with NEN regardless of COVID-19. However, older age, non-GEP primary sites and diabetes mellitus should be carefully considered for increased COVID-19 morbidity and mortality. Relevant information could be derived by integrating our results with NENs patients included in other cancer patients with COVID-19 registries.</p