FDG-PET in colorectal cancer.
[18F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is a useful imaging tool in the evolving management of patients with colorectal carcinoma. This technique is able to measure and visualize metabolic changes in cancer cells. This feature results in the ability to distinguish viable tumor from scar tissue, in the detection of tumor foci at an earlier stage than possible by conventional anatomic imaging and in the measurement of alterations in tumor metabolism, indicative of tumor response to therapy. Nowadays, FDG-PET plays a pivotal role in staging patients before surgical resection of recurrence and metastases, in the localization of recurrence in patients with an unexplained rise in serum carcinoembryonic antigen and in assessment of residual masses after treatment. In the presurgical evaluation, FDG-PET may be best used in conjunction with anatomic imaging in order to combine the benefits of both anatomical (CT) and functional (PET) information, which leads to significant improvements in preoperative liver staging and preoperative judgment on the feasibility of resection. Integration of FDG-PET into the management algorithm of these categories of patients alters and improves therapeutic management, reduces morbidity due to futile surgery, leads to substantial cost savings and probably also to a better patient outcome. FDG-PET also appears to have great potential in monitoring the success of local ablative therapies soon after intervention and in the prediction and evaluation of response to radiotherapy, systemic therapy, and combinations thereof. This review aims to outline the current and future role of FDG-PET in the field of colorectal cancer.
de Geus-Oei
Lioe-Fee
LF
Department of Nuclear Medicine, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands. l.degeus-oei@nucmed.umcn.nl
Ruers
Theo J M
TJ
Punt
Cornelis J A
CJ
Leer
Jan Willem
JW
Corstens
Frans H M
FH
Oyen
Wim J G
WJ
D000230:Adenocarcinoma / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary / Q000628:therapy; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D019788:Fluorodeoxyglucose F18; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography / Q000191:economics / Q000706:statistics & numerical data; D011300:Preoperative Care; D011379:Prognosis; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005472:Fluorouracil