title: Impact of 18F-FDG-positron emission tomography for decision making in colorectal cancer recurrences.
abstract: Diagnostic imaging for suspected tumour recurrence of primary colorectal cancer frequently lacks specificity and sensitivity. The impact of whole body 18F-FDG-positron-emission tomography (PET) on detection of local recurrences and hepatic or pulmonary metastases was evaluated in a prospective study. Results were compared with computed tomography (CT), ultrasonography, magnetic resonance imaging and conventional chest X-ray. The study included 71 patients (77 investigations) with suspected local recurrence, hepatic metastases or unexplained raised level of the tumour marker carcinoembryonic antigen (CEA). The results demonstrate that 18F-FDG-PET was clearly superior to CT with regard to detection of hepatic metastases. Sensitivity was 1.0 and specificity 0.98 compared with 0.87 and 0.91 for CT. In four cases, 18F-FDG-PET clarified otherwise unclear local recurrences. In five patients, 18F-FDG-PET showed pulmonary metastases that had previously been unknown. In a total of 16 patients (20.8%), 18F-FDG-PET provided additional information leading to a change of the treatment strategy. 18F-FDG-PET clearly has the ability to detect colorectal tumour recurrence and its metastases in a whole body format. Therefore, it may be applied in the follow-up of patients with primary colorectal cancer. Despite the costs, it is certainly recommended for patients with an otherwise unclear increase of CEA level or with unproven local recurrence.
authors.affiliation: Department of Surgery, University of Freiburg, Medical Center, Germany. imdahl@ch11.ukl.uni-freiburg.de
authors.forename: A
authors.initials: A
authors.lastname: Imdahl
authors.forename: M J
authors.initials: MJ
authors.lastname: Reinhardt
authors.forename: E U
authors.initials: EU
authors.lastname: Nitzsche
authors.forename: M
authors.initials: M
authors.lastname: Mix
authors.forename: A
authors.initials: A
authors.lastname: Dingeldey
authors.forename: A
authors.initials: A
authors.lastname: Einert
authors.forename: P
authors.initials: P
authors.lastname: Baier
authors.forename: E H
authors.initials: EH
authors.lastname: Farthmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18