Abstract
Purpose
To assess the role of positron emission tomography–computed tomography (PET–CT) and multidetector-row CT (MD-CT) in detecting the primary lesion and lymph node metastasis in patients with colorectal cancers.
Methods
A collective total of 80 lesions resected from 77 patients were examined pathologically. We analyzed the significance of the standardized uptake value (SUV) and its relationship with the clinicopathologic findings of primary lesions and lymph node metastasis. The detectability of primary lesions and lymph node metastases on PET–CT images was compared with that on MD-CT images.
Results
The detectability of primary lesions was better on PET–CT images than on MD-CT images (p = 0.0023). We observed no significant differences in the SUV with respect to staging, tumor grade, lymphatic or vessel invasion, and macroscopic type; however, primary tumor size analysis revealed that tumors larger than 3 cm had a higher SUV than those smaller than 3 cm. The sensitivity of PET–CT for detecting lymph node metastasis was lower than that of MD-CT, but the specificity of PET–CT was higher than that of MD-CT.
Conclusions
The SUV of primary cancers tends to increase in proportion to tumor size. Although the value of PET–CT in detecting lymph node metastasis is limited, PET -positive lymph nodes can be considered metastatic.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Shin S, Jeong Y, Min J, Kim H, Chung T, Kang H. Preoperative staging of colorectal cancer: CT vs. integrated FDG PET/CT. Abdom Imaging. 2008;33:270–7.
Furukawa H, Ikuma H, Seki A, Yokoe K, Yuen S, Aramaki T, et al. Positron emission tomography scanning is not superior to whole body multidetector helical computed tomography in the preoperative staging of colorectal cancer. Gut. 2006;55:1007–11.
Blodgett T, Meltzer C, Townsend D. PET/CT: form and function. Radiology. 2007;242:360–85.
Tomikawa M, Korenaga D, Akahoshi T, Kohshi K, Sugimachi K, Ikeda Y, et al. Trends in the treatment outcomes for advanced colorectal cancer: an analysis at a single community hospital in Japan. Surg Today. 2011;41:801–5.
Chessin D, Kiran R, Akhurst T, Guillem J. The emerging role of 18F-fluorodeoxyglucose positron emission tomography in the management of primary and recurrent rectal cancer. J Am Coll Surg. 2005;201:948–56.
Abdel-Nabi H, Doerr R, Lamonica D, Cronin V, Galantowicz P, Carbone G, et al. Staging of primary colorectal carcinomas with fluorine-18 fluorodeoxyglucose whole-body PET: correlation with histopathologic and CT findings. Radiology. 1998;206:755–60.
Cohade C, Osman M, Leal J, Wahl R. Direct comparison of 18F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med. 2003;44:1797–803.
Park I, Kim H, Yu C, Ryu M, Chang H, Kim J, et al. Efficacy of PET/CT in the accurate evaluation of primary colorectal carcinoma. Eur J Surg Oncol. 2006;32:941–7.
Selzner M, Hany T, Wildbrett P, McCormack L, Kadry Z, Clavien P. Does the novel PET/CT imaging modality impact on the treatment of patients with metastatic colorectal cancer of the liver? Ann Surg 2004;240:1027–34 (discussion 35–6).
Llamas-Elvira J, Rodríguez-Fernández A, Gutiérrez-Sáinz J, Gomez-Rio M, Bellon-Guardia M, Ramos-Font C, et al. Fluorine-18 fluorodeoxyglucose PET in the preoperative staging of colorectal cancer. Eur J Nucl Med Mol Imaging. 2007;34:859–67.
Davey K, Heriot A, Mackay J, Drummond E, Hogg A, Ngan S, et al. The impact of 18-fluorodeoxyglucose positron emission tomography–computed tomography on the staging and management of primary rectal cancer. Dis Colon Rectum. 2008;51:997–1003.
Nagata K, Ota Y, Okawa T, Endo S, Kudo S. PET/CT colonography for the preoperative evaluation of the colon proximal to the obstructive colorectal cancer. Dis Colon Rectum. 2008;51:882–90.
Agress HJ, Cooper B. Detection of clinically unexpected malignant and premalignant tumors with whole-body FDG PET: histopathologic comparison. Radiology. 2004;230:417–22.
Filippone A, Ambrosini R, Fuschi M, Marinelli T, Genovesi D, Bonomo L. Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography—initial experience. Radiology. 2004;231:83–90.
Kulinna C, Eibel R, Matzek W, Bonel H, Aust D, Strauss T, et al. Staging of rectal cancer: diagnostic potential of multiplanar reconstructions with MDCT. AJR Am J Roentgenol. 2004;183:421–7.
Tsunoda Y, Ito M, Fujii H, Kuwano H, Saito N. Preoperative diagnosis of lymph node metastases of colorectal cancer by FDG-PET/CT. Jpn J Clin Oncol. 2008;38:347–53.
Svrcek M, Cosnes J, Beaugerie L, Parc R, Bennis M, Tiret E, et al. Colorectal neoplasia in Crohn’s colitis: a retrospective comparative study with ulcerative colitis. Histopathology. 2007;50:574–83.
Green J, Timmcke A, Mitchell W, Hicks T, Gathright JJ, Ray J. Mucinous carcinoma—just another colon cancer? Dis Colon Rectum. 1993;36:49–54.
Berger K, Nicholson S, Dehdashti F, Siegel B. FDG PET evaluation of mucinous neoplasms: correlation of FDG uptake with histopathologic features. AJR Am J Roentgenol. 2000;174:1005–8.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Uchiyama, S., Haruyama, Y., Asada, T. et al. Role of the standardized uptake value of 18-fluorodeoxyglucose positron emission tomography–computed tomography in detecting the primary tumor and lymph node metastasis in colorectal cancers. Surg Today 42, 956–961 (2012). https://doi.org/10.1007/s00595-012-0225-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-012-0225-6