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Role of PET/CT in the detection of liver metastases from colorectal cancer

Ruolo della PET/TC nel rilevamento delle metastasi epatiche da carcinoma del colon-retto

  • Abdominal Radiology/Radiologia Addominale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to compare the diagnostic accuracy of 2-[fluorine-18] fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) and computed tomography (CT) with PET/CT in the detection of liver metastases during tumour staging in patients suffering from colorectal carcinoma for the purposes of correct surgical planning and follow-up.

Materials and methods

A total of 467 patients underwent a PET/CT scan using an iodinated contrast medium. We compared images obtained by the single PET scan, the single CT scan and by the fusion of the two procedures (PET/CT). The final diagnosis was obtained by histological examination and/or by the follow-up of all patients, including those who did not undergo surgery or biopsy.

Results

The PET scan had 94.05% sensitivity, 91.60% specificity and 93.36% accuracy; the CT scan had 91.07% sensitivity, 95.42% specificity and 92.29% accuracy. The combined procedures (PET/CT) had the following values: sensitivity 97.92%, specificity 97.71% and accuracy 97.86%.

Conclusions

This study indicates that PET/CT is very useful in staging and restaging patients suffering from colorectal cancer. It was particularly useful when recurrences could not be visualised either clinically or by imaging despite increasing tumour markers, as it guaranteed an earlier diagnosis. PET/CT not only provides high diagnostic performance in terms of sensitivity and specificity, enabling modification of patient treatment, but it is also a unique, high-profile procedure that can produce cost savings.

Riassunto

Obiettivo

Comparare l’accuratezza diagnostica della 18F-FDG-PET e della TC con quella della PET/TC nel rilievo di metastasi epatiche in pazienti affetti da carcinoma del colon-retto in fase di staging ai fini di un corretto planning chirurgico e follow-up.

Materiali e metodi

Sono stati valutati 467 pazienti mediante PET/TC effettuata con somministrazione di MdC organoiodato. È stata effettuata una comparazione tra le immagini ottenute dalla sola rilevazione PET, dalla sola rilevazione TC e quelle ottenute mediante fusione PET/TC. La diagnosi definitiva è stata ottenuta mediante conferma istologica e/o attraverso il follow-up di tutti i pazienti, anche di quelli non sottoposti a procedure bioptiche o ad intervento chirurgico.

Risultati

La tecnica PET è risultata avere una sensibilità pari al 94,05%, una specificità pari al 91,60% ed un’accuratezza del 93,36%; la tecnica TC una sensibilità pari al 91,07%, una specificità pari al 95,42% ed un’accuratezza del 92,29%. La tecnica combinata (PET/TC) è risultata avere una sensibilità pari al 97,92%, una specificità pari al 97,71%, ed un’accuratezza del 97,86%.

Conclusioni

La PET/TC è risultata di notevole utilità nella stadiazione e ristadiazione dei pazienti affetti da tumore del colon-retto. Essa è risultata particolarmente efficace quando, pur in presenza di un innalzamento progressivo dei marcatori, non era visualizzabile clinicamente o strumentalmente ripresa di malattia, garantendo così un’anticipazione diagnostica. La PET/TC non solo offre una performance diagnostica ottimale in termini di sensibilità e specificità, permettendo peraltro di modificare l’iter terapeutico del paziente, ma riveste anche caratteri di indagine unica di elezione, con conseguenti risparmi economici.

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Authors and Affiliations

  1. Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Policlinico Universitario “Tor Vergata”, Viale Oxford 81, 00133, Roma, Italy

    A. Orlacchio, O. Schillaci, N. Fusco, P. Broccoli, M. Yamgoue, R. Danieli, S. D’Urso & G. Simonetti

  2. Dipartimento di Sanità Pubblica, Cattedra di Igiene, Policlinico Universitario “Tor Vergata”, Viale Oxford 81, 00133, Roma, Italy

    M. Maurici

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  1. A. Orlacchio
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  2. O. Schillaci
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Correspondence to A. Orlacchio.

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Orlacchio, A., Schillaci, O., Fusco, N. et al. Role of PET/CT in the detection of liver metastases from colorectal cancer. Radiol med 114, 571–585 (2009). https://doi.org/10.1007/s11547-009-0393-7

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  • DOI: https://doi.org/10.1007/s11547-009-0393-7

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