, Volume 28, Issue 8, pp 584-590
Date: 24 Oct 2010

Application of 18F-fluorodeoxyglucose positron emission tomography to detection of proximal lesions of obstructive colorectal cancer

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Abstract

Purpose

In cases of obstructive colorectal cancer (CRC), preoperative diagnosis of the proximal lesion is often difficult when the primary lesion impedes the passage of the endoscope. The aim of this study was to evaluate the usefulness of fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in such cases.

Materials and methods

A total of 52 obstructive CRC patients who underwent preoperative FDG-PET and subsequent surgical resection were retrospectively reviewed. The correlation between characteristics of the proximal lesion and FDG-PET findings was analyzed statistically.

Results

There was a significant correlation between the proximal lesion size and the maximum standardized uptake value (P = 0.00016). Abnormal FDG accumulation in the proximal colon indicated the existence of proximal cancer or adenoma with a sensitivity of 50% and a specificity of 100%. There was a significant difference in the distribution of tumor size between the cases with proximal abnormal accumulation and those with no proximal accumulation (P = 0.00014). A proximal tumor of ≥8 mm can be demonstrated by an accumulation of FDG with a sensitivity of 94.1%.

Conclusion

FDG-PET can estimate the existence of a proximal lesion and its size. Results may contribute to decisions regarding the type of surgery in cases of obstructive CRC.