The incremental value of dual modality PET/CT imaging over PET imaging alone in advanced colorectal cancer
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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.
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.
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.
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.
KeywordsPETCT Advanced colorectal cancer Surgical management
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- 1.Childs AF, Blake M (2004) FDG-PET and PET/CT in Colon Cancer Restaging. J P Nuc Med http://brighamrad.harvard.edu/Cases/jpnm/hcache/1120/full.html
- 11.Zervos EE, Badgwell BD, Burak WE, Jr., Arnold MW, Martin EW (2001) Fluorodeoxyglucose positron emission tomography as an adjunct to carcinoembryonic antigen in the management of patients with presumed recurrent colorectal cancer and nondiagnostic radiologic workup. Surgery 130: 636–643PubMedCrossRefGoogle Scholar
- 23.Tann MA, Fletcher JW, McHenry L, Dewitt JM, LeBlanc JK, Howard TJ, Schmidt CM, Fogel EL, Sherman S, and Lehman GA (2003) FDG-PET/CT in the evaluation of cystic pancreatic tumours: comparison with endoscopic ultrasound fine needle aspiration. J Nucl Med 44(Suppl):24Google Scholar
- 24.Tatsumi M, Cohade C, Mourtzikos KA, and Wahl RL (2003) Initial experience with FDG PET-CT in the evaluation of breast cancer. J Nucl Med 44(Suppl):394Google Scholar
- 25.Nagabhushan N, Syed R, Hughes S, Gacinovic S, Costa DC, Visvikis D, Ell PJ, and Bomanji JB (2003) Advantages of using combined PET/CT in gynaecological tumours. J Nucl Med 44(Suppl):393Google Scholar
- 26.Tatsumi M, Cohade C, Zellars R, Bristow R, and Wahl RL (2003) Initial experience in imaging uterine cervical cancer with FDG PET-CT: direct comparison with PET. J Nucl Med 44(Suppl):394Google Scholar