PET/CT colonography for the preoperative evaluation of the colon proximal to the obstructive colorectal cancer.
OBJECTIVE
This study was designed to evaluate the usefulness of 18-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) colonography in preoperative diagnosis of the tumors proximal to obstructive colorectal cancers, which were defined as cancers that cannot be traversed colonoscopically.


METHODS
A whole-body PET/CT protocol for tumor staging and a protocol for CT colonography were integrated into one examination. No cathartic bowel preparation was used before this examination. Thirteen prospective patients with obstructive cancer were examined. We compared the detection rates for obstructive colorectal cancers and tumors proximal to the obstruction using air-inflated PET/CT colonography to intraoperative examinations, histopathologic outcome, and follow-up colonoscopy.


RESULTS
PET/CT colonography correctly identified all 13 primary obstructive colorectal cancers and all 2 synchronous colon cancers proximal to the obstruction. The two synchronous colon cancers detected at PET/CT colonography were confirmed and removed at single-stage surgical procedures. PET/CT colonography was able to localize all colorectal cancers precisely. There were no false-negative or false-positive proximal colorectal cancers by PET/CT colonography. Other preoperative examinations missed the synchronous colon cancers.


CONCLUSIONS
In patients with obstructive colorectal cancers, preoperative PET/CT colonography provided valuable anatomic and functional information of the entire colon to properly address surgery of colorectal cancer.
Nagata
Koichi
K
Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. Nagata7@aol.com
Ota
Yoshiko
Y
Okawa
Tomohiko
T
Endo
Shungo
S
Kudo
Shin-ei
SE
D000368:Aged; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000601:surgery; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D016896:Treatment Outcome; D051598:Whole Body Imaging
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18