title: Role of (18)F-FDG dual-head gamma-camera coincidence imaging in recurrent or metastatic colorectal carcinoma.
abstract: (18)F-FDG PET has been shown to be of high diagnostic accuracy for the evaluation of recurrent colorectal cancer. However, the limited availability of PET scanners precludes (18)F-FDG assessment of many patients for whom the study is indicated. An alternative is the SPECT system in coincidence mode. The aim of this study was to determine the role of dual-head camera (18)F-FDG coincidence imaging (DHC (18)F-FDG) in patients with recurrent colorectal cancer.
  
  
  METHODS
  Sixty-seven DHC (18)F-FDG studies were performed on 62 patients with suspected recurrent colorectal cancer. Reports of contemporary CT were available for the purpose of correlation for 61 of the studies. The final diagnosis of the imaging findings was based on histology or clinical and imaging follow-up of at least 6 mo.
  
  
  RESULTS
  In lesion-based analysis, 103 tumor sites were suspected on DHC (18)F-FDG, CT, or colonoscopy. Ninety-three of them were found to be true tumor sites. For DHC (18)F-FDG, the sensitivity was 88%, specificity was 80%, positive predictive value (PPV) was 98%, negative predictive value (NPV) was 42%, and accuracy was 87%. For CT, the sensitivity was 63%, specificity was 10%, PPV was 85%, NPV was 3%, and accuracy was 57%. In patient-based analysis, DHC (18)F-FDG differentiated patients with recurrent cancer from disease-free patients with a sensitivity of 91%, specificity of 73%, PPV of 94%, NPV of 62%, and accuracy of 88%. DHC (18)F-FDG detected tumor sites in 12 (67%) of 18 patients with elevated carcinoembryonic antigen and negative CT findings.
  
  
  CONCLUSIONS
  DHC (18)F-FDG is an adequate readily available technique for assessment of recurrent colorectal cancer and has a diagnostic accuracy better than that of CT.
authors: Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. evensap@tasmc.health.gov.il
authors: Einat
authors: E
authors: Even-Sapir
authors: Hedva
authors: H
authors: Lerman
authors: Arie
authors: A
authors: Figer
authors: Micha
authors: M
authors: Rabau
authors: Gennady
authors: G
authors: Livshitz
authors: Moshe
authors: M
authors: Inbar
authors: Mordechai
authors: M
authors: Gutman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18