title: Unnecessary surgery can be avoided by judicious use of PET/CT scanning in colorectal cancer patients.
abstract: OBJECTIVE
  This study aims to determine the role of positron emission tomography (PET)/computed tomography (CT) in changing the management plan in patients with metastatic or recurrent colorectal cancer (CRC) and to evaluate the role of PET/CT in patients with an unexplained rise in carcinoembryonic antigen (CEA).
  
  
  METHODS
  A total of 60 consecutive patients with CRC, who had PET/CT, were identified between 2008 and 2010. All patients had CT scans prior to the PET/CT. Data were collected from clinic letters, CT and PET CT reports and pathology results and cross-checked with the patient's notes.
  
  
  RESULTS
  Patients were aged between 43 and 85 years [33 males, 27 females]. CEA was raised in 37 patients and normal in 23. Results of PET/CT were compared with that of CT scan and 33 out of the 60 patients (55%) had PET/CT results which were different to that of CT scan and 27 patients (45%) had similar PET/CT and CT results. PET scan appropriately altered the management in 23/60 patients (38%) and avoided unnecessary surgery in 14 patients. PET/CT had a sensitivity of 86% and specificity of 84%. In patients with an unexplained rise in CEA, PET/CT was positive in only one out of ten (10%) patients.
  
  
  CONCLUSIONS
  PET/CT is valuable in deciding the management outcome in patients with metastatic or recurrent colorectal cancer. Unnecessary surgery might be avoided by careful use of PET/CT scanning in colorectal cancer patients. PET/CT might not be of value in patients with an unexplained rise in CEA.
authors.affiliation: James Cook University Hospital, Middlesbrough, UK. docaaa@gmail.com
authors.forename: Aliasger
authors.initials: A
authors.lastname: Amin
authors.forename: Anil
authors.initials: A
authors.lastname: Reddy
authors.forename: Robert
authors.initials: R
authors.lastname: Wilson
authors.forename: Madan
authors.initials: M
authors.lastname: Jha
authors.forename: Sumeet
authors.initials: S
authors.lastname: Miranda
authors.forename: Jasim
authors.initials: J
authors.lastname: Amin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D019564:Unnecessary Procedures
chemical_list: D002272:Carcinoembryonic Antigen