FDG-PET improves the staging and selection of patients with recurrent colorectal cancer.
Whole-body fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has proved effective in the diagnosis and staging of recurrent colorectal cancer. In this study, we analysed how PET affects the management of patients with recurrent colorectal cancer by permitting more accurate selection of candidates for curative resection. The data of 79 patients with known or suspected recurrent colorectal cancer were analysed. Conventional imaging modalities (CIM) and PET results were compared with regard to their accuracy in determining the extent and the resectability of tumour recurrence. Recurrence was demonstrated in 68 of the 79 patients. The data indicate that PET was superior to CIM for detection of recurrence at all sites except the liver. Based on the CIM+PET staging, surgery with curative intent was proposed in 39 patients and was indeed achieved in 31 of them (80%). PET was more accurate than CIM alone in predicting the resectability or non-resectability of the recurrence (82% vs 68%, P=0.02). It is concluded that whole-body FDG-PET is highly sensitive for both the diagnosis and the staging of patients with recurrent colorectal cancer. Its use in conjunction with conventional imaging procedures results in a more accurate selection of patients for surgical treatment with curative intent.
Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, avenue Hippocrate, 10, 1200 Brussels, Belgium. Max.Lonneux@mnuc.ucl.ac.be
Max
M
Lonneux
Abdel-Malek
AM
Reffad
Roger
R
Detry
Alex
A
Kartheuser
Jean-François
JF
Gigot
Stanislas
S
Pauwels
D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D004724:Endoscopy; D005188:False Negative Reactions; D005189:False Positive Reactions; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D009367:Neoplasm Staging; D018579:Patient Selection; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014915:Whole-Body Counting
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18