title: Reliability of (18)f-fluorodeoxyglucose positron emission tomography/computed tomography in the nodal staging of colorectal cancer patients.
abstract: OBJECTIVE
  Lymph-node metastasis is considered as critical prognostic factor in colorectal cancer. A preoperative evaluation of lymph-node metastasis can also help to determine the range of distant lymph node dissection. However, the reliability of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of lymph-node metastasis is not fully known.
  
  
  METHODS
  The medical records of 433 patients diagnosed with colorectal cancer were reviewed retrospectively. FDG-PET/CT and CT were performed on all patients. Lymph nodes were classified into regional and distant lymph nodes according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th edition.
  
  
  RESULTS
  The patients included 231 males (53.3%) and 202 females (46.7%), with a mean age of 64.7 ± 19.0 years. For regional lymph nodes, the sensitivity of FDG-PET/CT was lower than that of CT (57.1% vs. 73.5%, P < 0.001). For distant lymph nodes, the sensitivity of FDG-PET/CT was higher than that of CT (64.7% vs. 52.9%, P = 0.012). The sensitivity of FDG-PET/CT for regional lymph nodes was higher in patients with larger primary tumors. The positivity of lymph-node metastasis for FDG-PET/CT was affected by carcinoembryonic antigen levels, tumor location, and cancer stage for regional lymph nodes and by age and cancer stage for distant lymph nodes (P < 0.05).
  
  
  CONCLUSIONS
  The sensitivity of FDG-PET/CT for regional lymph-node metastasis was not superior to that of CT. However, FDG-PET/CT provides helpful information for determining surgical plan especially in high risk patients group.
authors.affiliation: Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Yi
authors.affiliation: Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Kyung Sook
authors.initials: KS
authors.lastname: Hong
authors.affiliation: Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Nara
authors.initials: N
authors.lastname: Moon
authors.affiliation: Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Soon Sup
authors.initials: SS
authors.lastname: Chung
authors.affiliation: Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Ryung-Ah
authors.initials: RA
authors.lastname: Lee
authors.affiliation: Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Kim
keywords: Colorectal neoplasms; Lymph node; Metastasis; Positron emission tomography