Positron emission tomography for preoperative staging of colorectal carcinoma.
OBJECTIVE
Positron emission tomography (PET) is an imaging technique based on in vivo cellular metabolism. Increased glucose metabolism in neoplastic cells is detected by using fluorine-18 deoxyglucose. In an ongoing pilot study to determine the usefulness of this technique, PET is compared with computerized tomography (CT) for the preoperative staging of colorectal carcinoma.


METHODS
Sixteen patients were evaluated with both PET and CT of the abdomen and pelvis. Results were compared with operative and histopathologic findings. Fifteen malignant lesions were found in 16 patients by histology. PET had a positive predictive value of 93 percent and a negative predictive value of 50 percent. By comparison CT had a positive predictive value of 100 percent and a negative predictive value of 27 percent.


CONCLUSIONS
These preliminary results indicate that PET has increased sensitivity for staging colorectal carcinoma, whereas CT has higher specificity. The predictive value of a positive PET compares favorably with CT. Furthermore, the predictive accuracy for detection of colorectal carcinoma is 83 percent for PET and 56 percent for CT.
Falk
P M
PM
Section of Colon and Rectal Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131.
Gupta
N C
NC
Thorson
A G
AG
Frick
M P
MP
Boman
B M
BM
Christensen
M A
MA
Blatchford
G J
GJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003847:Deoxyglucose; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D005462:Fluorine Radioisotopes; D003847:Deoxyglucose