Abstract
PURPOSE: Positron emission tomography (PET) is an imaging technique based onin vivo cellular metabolism. Increased glucose metabolism in neoplastic cells is detected by using fluorine-18 deoxyglucose. In an ongoing pilot study to determine the usefulness of this technique, PET is compared with computerized tomography (CT) for the preoperative staging of colorectal carcinoma. METHODS: Sixteen patients were evaluated with both PET and CT of the abdomen and pelvis. Results were compared with operative and histopathologic findings. Fifteen malignant lesions were found in 16 patients by histology. PET had a positive predictive value of 93 percent and a negative predictive value of 50 percent. By comparison CT had a positive predictive value of 100 percent and a negative predictive value of 27 percent. CONCLUSIONS: These preliminary results indicate that PET has increased sensitivity for staging colorectal carcinoma, whereas CT has higher specificity. The predictive value of a positive PET compares favorably with CT. Furthermore, the predictive accuracy for detection of colorectal carcinoma is 83 percent for PET and 56 percent for CT.
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References
Balhazar EJ, Megibow AJ, Hulnick D, Naidich DP. Carcinoma of the colon: detection and preoperative staging by CT. AJR 1988;150:301–6.
de Lange EE, Fechner RE, Edge SB, Spaulding CA. Preoperative staging of rectal carcinoma with MR imaging: surgical and histopathologic correlation. Radiology 1990;176:623–8.
Hildebrandt U, Feifel G. Preoperative staging of rectal cancer by intrarectal ultrasound. Dis Colon Rectum 1985;28:42–6.
Hildebrandt U, Klein T, Feifel G, Schwarz H-P, Koch B, Schmitt RM. Endosonography of pararectal lymph nodes:in vitro andin vivo evaluation. Dis Colon Rectum 1990;33:863–8.
Easter DW, Cuschieri A, Nathanson LK, Lavelle-Jones M. The utility of diagnostic laparoscopy for abdominal disorders: audit of 120 patients. Arch Surg 1992;127:379–83.
Duda RB, Zimmer AM, Rosen ST,et al. Radioimmune localization of occult carcinoma. Arch Surg 1990;125:866–70.
Kim EE, Tilbury RS, Haynie TP, Podoloff DA, Lamki LM, Dodd GD. Positron emission tomography in clinical oncology. Cancer Bull 1988;40:158–64.
Tayek JA. A review of cancer cachexia and abnormal glucose metabolism in humans with cancer. J Am Coll Nutr 1992;11:445–56.
Gupta NC, Mailliard JA, Bowman BM,et al. PETFDG imaging for followup evaluation of treated colorectal cancer (abstr.) Radiology 1991;181:199.
Schlag P, Lehner B, Strauss LG, Georgi P, Herfarth C. Scar or recurrent rectal cancer: positron emission tomography is more helpful for diagnosis than immunoscintigraphy. Arch Surg 1989;324:197–200.
Engenhart R, Kimmig BN, Strauss LG,et al. Therapy monitoring of presacral recurrences after high-dose irradiation: value of PET, CT, CEA and pain score. Strahlenther Onkol 1992;168:203–12.
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Presented in part in the Nebraska Medical Journal, February 1993.
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Falk, P.M., Gupta, N.C., Thorson, A.G. et al. Positron emission tomography for preoperative staging of colorectal carcinoma. Dis Colon Rectum 37, 153–156 (1994). https://doi.org/10.1007/BF02047538
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DOI: https://doi.org/10.1007/BF02047538