Whole-body PET/CT-colonography: a possible new concept for colorectal cancer staging.
BACKGROUND
Colorectal cancer (CRC) is a leading cause of death, and necessitates a conjointly performed staging. Until now, a multi-step-examination including optical colonoscopy, cross-sectional and functional imaging is recommended. However, a single examination for whole-body staging with a dedicated CRC staging protocol is desirable. Thus, we developed and evaluated a combined whole-body PET/CT-colonography protocol for dedicated CRC staging in routine clinical use.


METHODS
We integrated CT-colonography into a whole-body PET/CT protocol to achieve a specific "all-in-one" examination for patients suspected of having CRC. After oral and rectal bowel distension, PET/CT-colonography has been performed in 55 patients. All patients had optical colonoscopy one day before PET/CT. PET/CT data sets were evaluated concerning detection and evaluation of colorectal tumour sites, lymph nodes and distant metastases; these results were compared to the results of CT-colonography alone. Surgical resection and/or biopsy served as standards of reference in all patients.


RESULTS
All examinations were fully diagnostic and well tolerated by the patients. PET/CT-colonography showed highly accurate results for overall TNM-evaluation and was significantly more accurate than CT-colonography alone.


CONCLUSIONS
Staging patients with whole-body PET/CT-colonography is technically feasible and accurate. Patients with incomplete colonoscopy or potential synchronous bowel lesions might benefit from this approach.
Kinner
Sonja
S
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany. Sonja.Kinner@uni-due.de
Antoch
Gerald
G
Bockisch
Andreas
A
Veit-Haibach
Patrick
P
D001706:Biopsy; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000473:pathology; D023881:Colonography, Computed Tomographic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000473:pathology; D015203:Reproducibility of Results; D051598:Whole Body Imaging / Q000379:methods*