title: Positron emission tomography/computed tomography for optimized colon cancer staging and follow up.
abstract: OBJECTIVE
  Optimal management of colon cancer (CC) requires detailed assessment of extent of disease. This study prospectively investigates the diagnostic accuracy of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (PET/CT) for staging and detection of recurrence in primary CC.
  
  
  METHODS
  PET/CT for preoperative staging was performed in 66 prospectively included patients with primary CC. Diagnostic accuracy for PET/CT and CT was analyzed. In addition to routine follow up, 42 stages I-III CC patients had postoperative PET/CT examinations every 6 months for 2 years. Serological levels of tissue inhibitor of metalloproteinase-1 (TIMP-1), carcinoembryonic antigen, and liberated domain I of urokinase plasminogen activator receptor were analyzed.
  
  
  RESULTS
  Accuracy for tumor, nodal, and metastases staging by PET/CT were 82% (95% confidence interval [CI]: 70; 91), 66% (CI: 51; 78), and 89% (CI: 79; 96); for CT the accuracy was 77% (CI: 64; 87), 60% (CI: 46; 73), and 69% (CI: 57; 80). Cumulative relapse incidences for stages I-III CC at 6, 12, 18, and 24 months were 7.1% (CI: 0; 15); 14.3% (CI: 4; 25); 19% (CI: 7; 31), and 21.4% (CI: 9; 34). PET/CT diagnosed all relapses detected during the first 2 years. High preoperative TIMP-1 levels were associated with significant hazards toward risk of recurrence and shorter overall survival.
  
  
  CONCLUSIONS
  This study indicates PET/CT as a valuable tool for staging and follow up in CC. TIMP-1 provided prognostic information potentially useful in selection of patients for intensive follow up.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Næstved Hospital , Næstved , Denmark.
authors.forename: Bodil Elisabeth
authors.initials: BE
authors.lastname: Engelmann
authors.forename: Annika
authors.initials: A
authors.lastname: Loft
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjær
authors.forename: Hans Jørgen
authors.initials: HJ
authors.lastname: Nielsen
authors.forename: Anne Kiil
authors.initials: AK
authors.lastname: Berthelsen
authors.forename: Tina
authors.initials: T
authors.lastname: Binderup
authors.forename: Kim
authors.initials: K
authors.lastname: Brinch
authors.forename: Nils
authors.initials: N
authors.lastname: Brünner
authors.forename: Thomas Alexander
authors.initials: TA
authors.lastname: Gerds
authors.forename: Gunilla
authors.initials: G
authors.lastname: Høyer-Hansen
authors.forename: Michael Holmsgaard
authors.initials: MH
authors.lastname: Kristensen
authors.forename: Engin Yeter
authors.initials: EY
authors.lastname: Kurt
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Latocha
authors.forename: Gunnar
authors.initials: G
authors.lastname: Lindblom
authors.forename: Carsten
authors.initials: C
authors.lastname: Sloth
authors.forename: Liselotte
authors.initials: L
authors.lastname: Højgaard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis* / Q000556:secondary; D003110:Colonic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood; D016019:Survival Analysis; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D019275:Radiopharmaceuticals; D055293:Receptors, Urokinase Plasminogen Activator; D019715:Tissue Inhibitor of Metalloproteinase-1; D019788:Fluorodeoxyglucose F18