title: Positron emission tomography scanning is not superior to whole body multidetector helical computed tomography in the preoperative staging of colorectal cancer.
abstract: BACKGROUND
  The role of positron emission tomography with the glucose analogue [18F] fluoro-2-deoxy-D-glucose (FDG-PET) in the initial staging of disease in patients with primary colorectal cancer (CRC) has not been adequately assessed.
  
  
  OBJECTIVE
  To evaluate the additional value of FDG-PET as a staging modality, complementary to routine multidetector row computed tomography (MDCT) in patients with CRC.
  
  
  METHODS
  Forty four patients with CRC underwent preoperative MDCT and FDG-PET. The accuracy of intraoperative macroscopic staging was also investigated compared with histopathological diagnosis. All FDG-PET images were evaluated with respect to detectability of the primary tumour, lymph node involvement, and distant metastases. Both MDCT and FDG-PET diagnoses and treatment plan were compared with surgical and histopathological results.
  
  
  RESULTS
  Thirty seven patients underwent surgery. Tumour detection rate was 95% (42/44) for MDCT, 100% (44/44) for FDG-PET, and 100% (37/37) for intraoperative macroscopic diagnosis. Pathological diagnosis of T factor was T1 in five, T2 in four, T3 in 24, and T4 in four cases. Concordance rate with pathological findings of T factor was 57% (21/37) for MDCT and 62% (23/37) for macroscopic diagnosis. Lymph node involvement was pathologically positive in 19 cases. Regarding N factor, overall accuracy was 62% (23/37) for MDCT, 59% (22/37) for FDG-PET, and 70% (26/37) for macroscopic diagnosis. For all 44 patients, FDG-PET findings resulted in treatment changes in only one (2%) patient.
  
  
  CONCLUSIONS
  FDG-PET is not superior to routine MDCT in the initial staging of primary CRC.
authors.affiliation: Division of Diagnostic Radiology, Shizuoka Cancer Centre Hospital, 1007, Nagaizumi-cho, Suntogun, Shizuoka, 411-8777, Japan. h.furukawa@scchr.jp
authors.forename: H
authors.initials: H
authors.lastname: Furukawa
authors.forename: H
authors.initials: H
authors.lastname: Ikuma
authors.forename: A
authors.initials: A
authors.lastname: Seki
authors.forename: K
authors.initials: K
authors.lastname: Yokoe
authors.forename: S
authors.initials: S
authors.lastname: Yuen
authors.forename: T
authors.initials: T
authors.lastname: Aramaki
authors.forename: S
authors.initials: S
authors.lastname: Yamagushi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*; D051598:Whole Body Imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18