Recent chemotherapy reduces the sensitivity of [18F]fluorodeoxyglucose positron emission tomography in the detection of colorectal metastases.
OBJECTIVE
[18F]2-fluoro-2-deoxyglucose (FDG) -positron emission tomography (PET) has become a useful tool in the assessment of patients with colorectal cancer. Patients often undergo chemotherapy as treatment for primary or metastatic colorectal malignancy. Because cytotoxic chemotherapy may decrease the cellular metabolic activity of tumor, we assessed the effects of chemotherapy on PET imaging.


METHODS
This is a prospective study examining detection of hepatic colorectal metastases by FDG-PET as related to use of chemotherapy. Pathologic analysis of the liver resection specimens was used as gold standard.


RESULTS
There was significantly decreased tumor FDG uptake (as measured by the maximal standardized uptake value) in patients treated preoperatively with chemotherapy, resulting in less efficient detection of cancerous lesions. One biologic basis of this change in accuracy of PET was a significant decrease in the activity of the key glycolytic enzyme hexokinase in tumors from patients treated with chemotherapy.


CONCLUSIONS
These results indicate that FDG-PET scanning should be interpreted in the context of concurrent cytotoxic therapy. FDG-PET scanning results may also be useful in assessment of response to such cytotoxic therapies.
Akhurst
Timothy
T
Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA.
Kates
Tara J
TJ
Mazumdar
Madhu
M
Yeung
Henry
H
Riedel
Elyn R
ER
Burt
Bryan M
BM
Blumgart
Leslie
L
Jarnagin
William
W
Larson
Steven M
SM
Fong
Yuman
Y
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D005260:Female; D019788:Fluorodeoxyglucose F18; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000187:drug effects / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D012044:Regression Analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D019788:Fluorodeoxyglucose F18; D005472:Fluorouracil