Abstract
INTRODUCTION: Several studies have been performed comparing computed tomography scan with positron emission tomography scan in clinical decision making. Unfortunately, therapeutic decisions are being made based on positron emission tomography scan data without a clear understanding of how well the diagnostic findings correlate with the clinical findings. METHODS: A retrospective review of 41 patients with metastatic colorectal cancer was performed. All patients had both a computed tomography scan and a positron emission tomography scan before surgical exploration. All underwent surgical re-exploration. Findings were divided into hepatic, extrahepatic, and pelvic regions of the abdomen. Computed tomography scan and positron emission tomography scan findings were either confirmed or refuted by the operative findings. RESULTS: Positron emission tomography scan was found to be more sensitive than computed tomography scan when compared with actual operative findings in the liver (100vs. 69 percent,P=0.004), extrahepatic region (90vs. 52 percent,P=0.015), and abdomen as a whole (87vs. 61 percent,P<0.001). Sensitivities of positron emission tomography scan and computed tomography scan were not significantly different in the pelvic region (87vs. 61 percent,P=0.091). In each case, specificity was not significantly different between the two examinations. CONCLUSION: Computed tomography scan and positron emission tomography scan are both diagnostic tests useful in the evaluation of metastatic colorectal cancer. However, positron emission tomography scanning is more sensitive than computed tomography scanning and more likely to give the correct result when actual metastatic disease is present.
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References
Ogunbiyi OA, Flanagan FL, Dehdashti F,et al. Detection of recurrent and metastatic colorectal cancer: comparison of positron emission tomography and computed tomography. Ann Surg Oncol 1997;4:613–20.
Moertel CG, Fleming TR, Macdonald JS,et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 1990;322:352–8.
Markowitz AJ, Winawer SJ. Colonoscopic surveillance after treatment of colorectal polyps or cancer. Semin Colon Rectal Surg 2000;11:41–8.
Valk PE, Abella-Columna E, Haseman MK,et al. Wholebody PET imaging with [18F]fluorodeoxyglucose in management of recurrent colorectal cancer. Arch Surg 1999;134:503–11.
Schiepers C, Penninckx F, De Vadder N. Contribution of PET in the diagnosis of recurrent colorectal cancer: comparison with conventional imaging. Eur J Surg Oncol 1995;21:517–22.
Vitola JV, Delbeke D, Sandler MP,et al. Positron emission tomography to stage suspected metastatic colorectal carcinoma to the liver. Am J Surg 1996;171:21–6.
Moog F, Kotzerke J, Reske SN. FDG PET can replace bone scintigraphy in primary staging of malignant lymphoma. J Nucl Med 1999;40:1407–13.
Valk PE, Pounds TR, Tesar RD, Hopkins DM, Haseman MK. Cost-effectiveness of PET imaging in clinical oncology. Nucl Med Biol 1996;23:737–43.
Strauss LG. Fluorine-18 deoxyglucose and false-positive results: a major problem in the diagnostics of oncological patients. Eur J Nucl Med 1996;23:1409–15.
Delbeke D, Vitola JV, Sandler MP,et al. Staging recurrent metastatic colorectal carcinoma with PET. J Nucl Med 1997;38:1196–201.
Yasuda S, Makuuchi Y, Sadahiro S,et al. Colorectal cancer recurrence in the liver: detection by PET. Tokai J Exp Clin Med 1998;23:167–71.
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Johnson, K., Bakhsh, A., Young, D. et al. Correlating computed tomography and positron emission tomography scan with operative findings in metastatic colorectal cancer. Dis Colon Rectum 44, 354–357 (2001). https://doi.org/10.1007/BF02234732
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DOI: https://doi.org/10.1007/BF02234732