title: Selective Use of (18)F-Fluorodeoxyglucose-Positron Emission Tomography and Computed Tomography in the Management of Metastatic Disease from Colorectal Cancer: Results from a regional centre.
abstract: OBJECTIVE
  Computed tomography (CT) scans are routinely used for primary staging and disease surveillance in patients with colorectal cancer. However, these scans have limited sensitivity in some organs and can only detect lesions with morphological changes, whereas (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG-PET) scans are able to detect areas of metabolic change before morphological changes appear. The aim of this study was to evaluate the impact of (18)F-FDG-PET/CT scans over conventional imaging during preoperative work-ups or follow-ups in a selected group of patients.
  
  
  METHODS
  This retrospective cohort study, which took place between July 2009 and May 2011, assessed 1,043 patient records from the South East Scotland Cancer Network colorectal cancer database. A total of 102 patients who underwent (18)F-FDG-PET/CT scans in addition to conventional imaging were included in the study. These patients had potentially resectable metastases, equivocal findings on CT scans and elevated carcinoembryonic antigen levels with negative conventional imaging.
  
  
  RESULTS
  Of the 102 patients included in the study, 22 underwent a preoperative (18)F-FDG-PET/CT scan and 80 underwent a follow-up 18F-FDG-PET/CT scan. In the preoperative scan group, the (18)F-FDG-PET/CT scan had a major impact on 16 patients (72.75%) and no impact on six patients (27.25%). In the follow-up scan group, the (18)F-FDG-PET/CT scan had a major impact on 51 (63.75%), a minor impact on four (5%), no impact on 22 (27.5%) and a negative impact on three (3.75%) patients.
  
  
  CONCLUSIONS
  The results of this study demonstrated that (18)F-FDG-PET/CT scans have a considerable effect on disease management when undertaken among indicated colorectal cancer patients.
authors: Colorectal Unit, Western General Hospital, Edinburgh, UK.
authors: Sadaf
authors: S
authors: Jafferbhoy
authors: Colorectal Unit, Western General Hospital, Edinburgh, UK.
authors: Adam
authors: A
authors: Chambers
authors: Colorectal Unit, Western General Hospital, Edinburgh, UK.
authors: James
authors: J
authors: Mander
authors: Colorectal Unit, Western General Hospital, Edinburgh, UK.
authors: Hugh
authors: H
authors: Paterson
keywords: 18F Fluorodeoxyglucose; Cancer Staging; Carcinoembryonic Antigen; Colorectal Cancer; Metastases; Positron Emission Tomography; Recurrence; United Kingdom