Utility of low dose (18)F-FDG PET-CT in patients with suspected colorectal carcinoma recurrence in conventional diagnostic methods.
OBJECTIVE
To evaluate the efficacy of (18)F-FDG PET-CT in the diagnosis of recurrence of colorectal cancer (CRC) in patients with elevated values of carcinoembryonic antigen (CEA) and/or signs of recurrence in the multidetector CT (MDCT), and to demonstrate that good results can be obtained applying the ALARA principles.


METHODS
A retrospective study of 54 patients with suspected CRC, who underwent an (18)F-FDG PET-CT, administering a mean dose of 222 MBq (6 mCi) of (18)F-FDG, from 07/2007 to 01/2011 was carried out. Seven patients were excluded, thus studying 47 (27 males, 20 females, mean age 63 years). Recurrence was confirmed by histopathology study in 14 cases and by clinical evolution in 33. The patients were divided into 4 groups. A: patients with elevation of CEA and suspected recurrence in the MDCT. B: elevation of CEA, without suspicious lesions in the MDCT. C: normal levels of CEA and positive MDCT. D: normal levels of CEA and uncertain MDCT.


RESULTS
We found sensitivity, specificity, PPV, NPV and overall accuracy of 91%, 69%, 89%, 75% and 85% respectively. For group A, we found 100% sensitivity, in group B, 75% sensitivity with 100% specificity%, for C, sensitivity was 89% with 71% specificity. Finally, in group D, sensitivity was 100% and specificity 60%, respectively.


CONCLUSIONS
Applying a low dose, the (18)F-FDG PET-CT has high diagnostic performance in patients with suspicion of CRC, approaching in a higher grade the ALARA criteria.
Departamento de Medicina Nuclear, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain. migue8a@hotmail.com
M A
MA
Ochoa-Figueroa
J
J
Uña-Gorospe
A
A
Allende-Riera
J C
JC
Cárdenas-Negro
J
J
Muñoz-Iglesias
D
D
Cabello-García
M
M
De Sequera-Rahola
E
E
Martínez-Gimeno
D000230:Adenocarcinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001932:Brain Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary; D002272:Carcinoembryonic Antigen / Q000097:blood; D059248:Chemoradiotherapy; D015179:Colorectal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary*; D008175:Lung Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18