Indian Journal of Surgery

, Volume 71, Issue 2, pp 63–68

The incremental value of dual modality PET/CT imaging over PET imaging alone in advanced colorectal cancer

  • A. H. Engledow
  • G. E. L. Bond-Smith
  • D. Francis
  • F. Pakzad
  • J. Bomanji
  • A. Groves
  • P. J. Ell
Original Article

Abstract

Background

18Fluoro-2-Deoxy Glucose (18 FDG) positron emission tomography (PET) impacts upon the management of recurrent colorectal cancer (CRC) but is limited by anatomical localisation. The development of integrated positron emission and computerised tomography (PET/CT) yields high anatomical resolution combined with the PET data. We evaluate the added value of PET/CT over PET alone.

Method

Thirty-one consecutive patients had PET/CT for suspected recurrent CRC. Two blinded observers (A and B) reported images from PET alone and from integrated PET/CT. Lesion detection, lesion localisation, diagnostic certainty and impact on surgical management was assessed for each data set and then compared. The minimum clinical follow up was for 8 months (median 9.6 months) and 7 patients had histological confirmation of diagnosis.

Results

Compared to PET alone, PET/CT the percentage of lesions accurately localised increased from 96% to 99% for observer A and 86% to 99% for Observer B. PET/CT increased the number of lesions reported as definitely abnormal or normal from 78% to 95% for Observer A and from 72% to 94% for Observer B. Surgical management was changed in 6 patients (19%). Inter-observer variability was reduced with PET/CT.

Conclusion

PET/CT improves the accuracy of reporting in recurrent colorectal cancer and influences surgical management in a significant proportion of patients when compared to PET only imaging.

Keywords

PETCT Advanced colorectal cancer Surgical management 

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Copyright information

© Association of Surgeons of India 2009

Authors and Affiliations

  • A. H. Engledow
    • 1
  • G. E. L. Bond-Smith
    • 1
  • D. Francis
    • 2
  • F. Pakzad
    • 1
  • J. Bomanji
    • 3
  • A. Groves
    • 3
  • P. J. Ell
    • 3
  1. 1.Department of Colorectal and Laparoscopic SurgeryChase Farm HospitalEnfieldUSA
  2. 2.Department of Laparoscopic SurgeryChase Farm HospitalEnfieldUSA
  3. 3.Department of Nuclear MedicineUniversity College Hospital LondonLondonUK

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