BACKGROUND: The role of positron emission tomography with the glucose analogue [18F] fluoro-2-deoxy-D-glucose (FDG-PET) in the initial staging of disease in patients with primary colorectal cancer (CRC) has not been adequately assessed. AIMS: To evaluate the additional value of FDG-PET as a staging modality, complementary to routine multidetector row computed tomography (MDCT) in patients with CRC. METHODS: Forty four patients with CRC underwent preoperative MDCT and FDG-PET. The accuracy of intraoperative macroscopic staging was also investigated compared with histopathological diagnosis. All FDG-PET images were evaluated with respect to detectability of the primary tumour, lymph node involvement, and distant metastases. Both MDCT and FDG-PET diagnoses and treatment plan were compared with surgical and histopathological results. RESULTS: Thirty seven patients underwent surgery. Tumour detection rate was 95% (42/44) for MDCT, 100% (44/44) for FDG-PET, and 100% (37/37) for intraoperative macroscopic diagnosis. Pathological diagnosis of T factor was T1 in five, T2 in four, T3 in 24, and T4 in four cases. Concordance rate with pathological findings of T factor was 57% (21/37) for MDCT and 62% (23/37) for macroscopic diagnosis. Lymph node involvement was pathologically positive in 19 cases. Regarding N factor, overall accuracy was 62% (23/37) for MDCT, 59% (22/37) for FDG-PET, and 70% (26/37) for macroscopic diagnosis. For all 44 patients, FDG-PET findings resulted in treatment changes in only one (2%) patient. CONCLUSION: FDG-PET is not superior to routine MDCT in the initial staging of primary CRC.
BACKGROUND: The role of positron emission tomography with the glucose analogue [18F] fluoro-2-deoxy-D-glucose (FDG-PET) in the initial staging of disease in patients with primary colorectal cancer (CRC) has not been adequately assessed. AIMS: To evaluate the additional value of FDG-PET as a staging modality, complementary to routine multidetector row computed tomography (MDCT) in patients with CRC. METHODS: Forty four patients with CRC underwent preoperative MDCT and FDG-PET. The accuracy of intraoperative macroscopic staging was also investigated compared with histopathological diagnosis. All FDG-PET images were evaluated with respect to detectability of the primary tumour, lymph node involvement, and distant metastases. Both MDCT and FDG-PET diagnoses and treatment plan were compared with surgical and histopathological results. RESULTS: Thirty seven patients underwent surgery. Tumour detection rate was 95% (42/44) for MDCT, 100% (44/44) for FDG-PET, and 100% (37/37) for intraoperative macroscopic diagnosis. Pathological diagnosis of T factor was T1 in five, T2 in four, T3 in 24, and T4 in four cases. Concordance rate with pathological findings of T factor was 57% (21/37) for MDCT and 62% (23/37) for macroscopic diagnosis. Lymph node involvement was pathologically positive in 19 cases. Regarding N factor, overall accuracy was 62% (23/37) for MDCT, 59% (22/37) for FDG-PET, and 70% (26/37) for macroscopic diagnosis. For all 44 patients, FDG-PET findings resulted in treatment changes in only one (2%) patient. CONCLUSION: FDG-PET is not superior to routine MDCT in the initial staging of primary CRC.
Authors: C Kulinna; R Eibel; W Matzek; H Bonel; D Aust; T Strauss; M Reiser; J Scheidler Journal: AJR Am J Roentgenol Date: 2004-08 Impact factor: 3.959
Authors: B Topal; P Flamen; R Aerts; A D'Hoore; L Filez; E Van Cutsem; L Mortelmans; F Penninckx Journal: Eur J Surg Oncol Date: 2001-03 Impact factor: 4.424
Authors: P Som; H L Atkins; D Bandoypadhyay; J S Fowler; R R MacGregor; K Matsui; Z H Oster; D F Sacker; C Y Shiue; H Turner; C N Wan; A P Wolf; S V Zabinski Journal: J Nucl Med Date: 1980-07 Impact factor: 10.057
Authors: Eric P van der Stok; Manon C W Spaander; Dirk J Grünhagen; Cornelis Verhoef; Ernst J Kuipers Journal: Nat Rev Clin Oncol Date: 2016-12-20 Impact factor: 66.675
Authors: Monique Maas; Iris J G Rutten; Patty J Nelemans; Doenja M J Lambregts; Vincent C Cappendijk; Geerard L Beets; Regina G H Beets-Tan Journal: Eur J Nucl Med Mol Imaging Date: 2011-04-06 Impact factor: 9.236