Is (18)F-fluorodeoxyglucose positron emission tomography in recurrent colorectal cancer a contribution to surgical decision making?
BACKGROUND
Accuracy of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) and contribution to surgical decision making in recurrent or metastatic colorectal cancer were evaluated.


METHODS
One hundred whole-body PET tests in colorectal cancer patients (1994 to 1998) were compared with computed tomography (CT), liver ultrasonography, and carcinoembryonic antigen (CEA) test. Mean follow-up was 12 months.


RESULTS
Sensitivity, specificity, and accuracy of FDG-PET for malignant findings were, respectively, 98%, 90% and 95%; for 87 CT scans, 91%, 72%, and 82%; for 98 CEA tests, 76%, 90%, and 82%; for detection of liver metastases with PET, 100%, 99%, and 99%; and for 68 ultrasound tests, 87%, 96%, and 93%. PET accuracy for local recurrence was 96%. Additional information was provided by PET in 86% of cases (abdomen, thorax, liver). PET influenced surgical decisions in 61% of cases.


CONCLUSIONS
FDG-PET adds relevant accuracy to the conventional staging of patients with colorectal cancer and may cost-effectively help to select the appropriate treatment.
Staib
L
L
Department of General Surgery, University of Ulm, Ulm/Donau, Germany.
Schirrmeister
H
H
Reske
S N
SN
Beger
H G
HG
D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000032:analysis; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D003657:Decision Making; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000601:surgery; D010347:Patient Care Planning; D019275:Radiopharmaceuticals; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D012680:Sensitivity and Specificity; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D002272:Carcinoembryonic Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18