title: Fusion image of positron emission tomography and computed tomography for the diagnosis of local recurrence of rectal cancer.
abstract: BACKGROUND
  The aim of this study was to evaluate the clinical and therapeutic value of digital fusion image (FI) of positron emission tomography (PET) using (18)F-fluorodeoxy glucose and computed tomography (CT) in patients who were suspected of having a local recurrence of rectal cancer.
  
  
  METHODS
  Forty-two patients (32 men and 10 women; mean age, 61.4 years, range, 40-79 years) with a suspicion of local recurrence after curative resection of rectal cancer were prospectively recruited and underwent (18)F-fluorodeoxy glucose-PET and CT. The FI was reconstructed with a commercially available digital software program, T-B Fusion. Wilcoxon signed rank test was used to compare FI with CT alone or PET alone.
  
  
  RESULTS
  FI yielded a correct diagnosis in 39 (93%) of 42 patients, whereas CT alone and PET alone did so in 33 (79%) and 37 (88%) patients, respectively. FI had better diagnostic accuracy than CT alone (P = .0138) and PET alone (P = .0156). Overall, FI altered patient management in 11 (26.2%) patients on the basis of additional information, including differentiation of the tumor from the postoperative scar in 6 patients, exact anatomical location in 3 patients, and both in 2 patients.
  
  
  CONCLUSIONS
  FI has a potential clinical value in the treatment of suspected local recurrence of rectal cancer.
authors.affiliation: Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Fukunaga
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.forename: Ichiro
authors.initials: I
authors.lastname: Higuchi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yasui
authors.forename: Iwao
authors.initials: I
authors.lastname: Seshimo
authors.forename: Osamu
authors.initials: O
authors.lastname: Takayama
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohue
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Tatsumi
authors.forename: Jun
authors.initials: J
authors.lastname: Hatazawa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ikenaga
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D000368:Aged; D003082:Colectomy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18