title: Clinical impact of FDG-PET/CT on colorectal cancer staging and treatment strategy.
abstract: FDG-PET/CT is rarely used for initial staging of patients with colorectal cancer (CRC). Surgical resection of primary tumor and isolated metastases may result in long-term survival or presumed cure, whereas disseminated disease contraindicates operation. We analyzed a retrospective material to elucidate the potential value of FDG-PET/CT for staging of CRC. Data were retrieved from 67 consecutive patients (24-84 years) with histopathologically proven CRC who had undergone FDG-PET/CT in addition to conventional imaging for initial staging. Treatment plans before and after FDG-PET/CT were compared and patients divided as follows: (A) Patients with a change in therapy following FDG-PET/CT and (B) Patients without a change following FDG-PET/CT. Sixty-two patients had colon and five had rectal cancer. Of these, 20 (30%; CI 20.2-41.7) belonged to group A, whereas 47 (70%; CI 58.3-79.8) fell in group B. In conclusion, FDG-PET/CT changed treatment plan in 30% of cases. In ⅓ of these there was either a change from intended curative to palliative therapy or vice versa, while in the remaining ⅔ the pattern was more mixed. Thus, even in a retrospective routine material there were substantial changes in management strategy following FDG-PET/CT for staging in CRC.
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital Denmark.
authors.forename: Rasmus K
authors.initials: RK
authors.lastname: Petersen
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Hess
authors.affiliation: Division of Nuclear Medicine, University of Pennsylvania School of Medicine, Hospital of The University of Pennsylvania Philadelphia, PA, USA.
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital Denmark.
authors.forename: Poul F
authors.initials: PF
authors.lastname: Høilund-Carlsen
keywords: FDG-PET/CT; clinical impact; colorectal cancer; treatment strategy