Positron emission tomography scanning is not superior to whole body multidetector helical computed tomography in the preoperative staging of colorectal cancer. Issue 7 (16th December 2005)

• Record Type: Journal Article
• Authors: Furukawa, H; Ikuma, H; Seki, A; Yokoe, K; Yuen, S; Aramaki, T; Yamagushi, S
• Is Part Of: Gut. Volume 55:Issue 7(2006)
• Page Start: 1007
• Page End: 1011
• Publication Date: 2005-12-16
• Subjects: PET, positron emission tomography -- FDG-PET, [18F] fluoro-2-deoxy-D-glucose-positron emission tomography -- CRC, colorectal cancer -- CT, computed tomography -- MDCT, multidetector row computed tomography; positron emission tomography -- colorectal surgery -- spiral computed tomography -- colorectal neoplasms -- neoplasm staging; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.2005.076273
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: The role of positron emission tomography with the glucose analogue [18F] fluoro-2-deoxy-D-glucose (FDG-PET) in the initial staging of disease in patients with primary colorectal cancer (CRC) has not been adequately assessed. Aims: To evaluate the additional value of FDG-PET as a staging modality, complementary to routine multidetector row computed tomography (MDCT) in patients with CRC. Methods: Forty four patients with CRC underwent preoperative MDCT and FDG-PET. The accuracy of intraoperative macroscopic staging was also investigated compared with histopathological diagnosis. All FDG-PET images were evaluated with respect to detectability of the primary tumour, lymph node involvement, and distant metastases. Both MDCT and FDG-PET diagnoses and treatment plan were compared with surgical and histopathological results. Results: Thirty seven patients underwent surgery. Tumour detection rate was 95% (42/44) for MDCT, 100% (44/44) for FDG-PET, and 100% (37/37) for intraoperative macroscopic diagnosis. Pathological diagnosis of T factor was T1 in five, T2 in four, T3 in 24, and T4 in four cases. Concordance rate with pathological findings of T factor was 57% (21/37) for MDCT and 62% (23/37) for macroscopic diagnosis. Lymph node involvement was pathologically positive in 19 cases. Regarding N factor, overall accuracy was 62% (23/37) for MDCT, 59% (22/37) for FDG-PET, and 70% (26/37) for macroscopic diagnosis. For all 44 patients, FDG-PET findings resulted in treatment changes in only one (2%) patient. Conclusion: FDG-PET is not superior to routine MDCT in the initial staging of primary CRC.