title: PET/CT detects abdominal wall and port site metastases of colorectal carcinoma.
abstract: Abdominal wall metastases from colorectal cancer (CRC) may be resected with curative results. Such lesions, often indicators of additional intra-abdominal lesions, may appear in surgical scars, stomas and port site metastases after laparoscope-assisted surgery (LAS). Post-operative changes, primarily surgical scars, alter local physical findings making early detection of small lesions challenging. The purpose of this study was to retrospectively evaluate the contribution of PET/CT to the diagnosis of recurrent colorectal cancer in the post-operative abdominal wall. 120 patients were referred for PET/CT with suspected recurrent CRC based on clinical, radiological or laboratory findings. All underwent whole body PET/CT imaging. 12 of these 120 (10%), were found to have abdominal wall lesions. A total of 16 abdominal wall lesions were detected, located to surgical scars, stomas, drain and laparoscope ports. Additional findings on PET/CT in this group included liver metastases, intra-abdominal lesions and retroperitoneal lymph node involvement. In general, the patients in this small group were young with high grade tumours presenting in advanced stages. In conclusion, PET/CT appears to be a sensitive tool for the diagnosis of abdominal wall recurrence of CRC. The accuracy of localization afforded by the fused functional and anatomic images makes PET/CT a likely tool for diagnosing abdominal wall lesions, including port site metastases of other aetiologies.
authors.affiliation: Department of Nuclear Medicine, The Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Goshen
authors.forename: T
authors.initials: T
authors.lastname: Davidson
authors.forename: D
authors.initials: D
authors.lastname: Aderka
authors.forename: S T
authors.initials: ST
authors.lastname: Zwas
mesh_terms: D034861:Abdominal Wall / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D009366:Neoplasm Seeding; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18