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KMID : 1148920120460030189
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Nuclear Medicine and Molecular Imaging
2012 Volume.46 No. 3 p.189 ~ p.195
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Value of Surveillance 18F-FDG PET/CT in Colorectal Cancer: Comparison with Conventional Imaging Studies
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Choi Eun-Kyoung
Yoo Ie-Ryung
Park Hye-Lim
Choi Hyun-Su
Han Eun-Ji
Kim Sung-Hoon
Chung Soo-Kyo
O Joo-Hyun
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Abstract
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Purpose: To assess the value of PET/CT for detecting local or distant recurrence in patients who undergo surgery for colorectal cancer (CRC) and to compare the accuracy of PET/CT to that of conventional imaging studies (CIS).
Methods: Tumor surveillance PET/CT scans done between March 2005 and December 2009 of disease-free patients after surgery with or without adjuvant chemotherapy for CRC were retrospectively studied. CIS (serial enhanced CT from lung base to pelvis and plain chest radiograph) were performed within 1 month of PET/CT. We excluded patients with distant metastasis on initial staging, a known recurrent tumor, and a lack of follow-up imaging. The final diagnosis was based on at least 6 months of follow-up with colonoscopy, biopsy, and serial imaging studies in combination with carcinoembryonic antigen levels.
Results: A total of 262 PET/CT scans of 245 patients were included. Local and distant recurrences were detected in 27 cases (10.3%). On case-based analysis, the overall sensitivity, specificity, and accuracy were 100, 97.0, and 97.3% for PET/CT and 85.1, 97.0, and 95.8% for CIS, respectively. On lesion-based analysis, PET/CT detected more lesions compared to CIS in local recurrence and lung metastasis. PET/CT and CIS detected the same number of lesions in abdominal lymph nodes, hepatic metastasis, and peritoneal carcinomatosis. PET/CT detected two more metachronous tumors than did CIS in the lung and thyroid gland.
Conclusion: PET/CT detected more recurrences in patients who underwent surgery for CRC than did CIS and had the additional advantage of evaluating the entire body during a single scan.
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KEYWORD
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Colorectal cancer, PET/CT, Surveillance
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