title: To PET or not to PET? That is the question. Staging in anal cancer.
abstract: BACKGROUND
  Anal cancer is a rare tumour accounting for ∼2% of all colorectal cancers between 1997 and 2000 in the UK. Staging is still dominated by DRE (digital rectal examination), computed tomography (CT) and magnetic resonance imaging (MRI) imaging. The role of PET as a definitive modality is still emerging and there are relatively few adequate studies in the literature.
  
  
  METHODS
  We looked at patients treated radically for anal cancer at Mount Vernon Cancer Centre (UK) between 2009 and 2010. Eighty-eight patients underwent treatment according to data-based coding records of which 46 had positron emission tomography (PET)/CT scans. Notes were unavailable for three patients. We compared staging following conventional modalities (DRE, MRI and CT) and PET/CT scans for these 43 patients.
  
  
  RESULTS
  In 18 patients, the PET/CT stage differed from MRI. PET/CT altered the stage in 42% of patients but changes in subsequent management were not implemented.
  
  
  CONCLUSIONS
  Our data show that PET/CT does alter staging in a significant number of cases although it did not lead to change in management under the current guidelines. Furthermore, there is agreement that PET/CT shows greater sensitivity for detection of lymph nodes and our study has demonstrated a distinct trend towards upstaging of anal cancer with PET/CT.
authors.affiliation: Department of Radiotherapy, Oncology Division, Mount Vernon Cancer Centre, Middlesex, UK. Electronic address: neel.bhuva@nhs.net.
authors.forename: N J
authors.initials: NJ
authors.lastname: Bhuva
authors.affiliation: Department of Radiotherapy, Oncology Division, Mount Vernon Cancer Centre, Middlesex, UK.
authors.forename: R
authors.initials: R
authors.lastname: Glynne-Jones
authors.affiliation: Department of Radiotherapy, Oncology Division, Mount Vernon Cancer Centre, Middlesex, UK.
authors.forename: L
authors.initials: L
authors.lastname: Sonoda
authors.affiliation: Department of Radiotherapy, Oncology Division, Mount Vernon Cancer Centre, Middlesex, UK.
authors.forename: W-L
authors.initials: WL
authors.lastname: Wong
authors.affiliation: Department of Radiotherapy, Oncology Division, Mount Vernon Cancer Centre, Middlesex, UK.
authors.forename: M K
authors.initials: MK
authors.lastname: Harrison
mesh_terms: D001005:Anus Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18