FDG-PET improves the staging and selection of patients with recurrent colorectal cancer

• Published in: European journal of nuclear medicine and molecular imaging Vol. 29; no. 7; pp. 915 - 921
• Main Authors: LONNEUX, Max, REFLAD, Abdel-Malek, DETRY, Roger, KARTHEUSER, Alex, GIGOT, Jean-Francois, PAUWELS, Stanislas
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-07-2002; Springer Nature B.V
• Subjects: Biological and medical sciences; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - diagnostic imaging; Colorectal Neoplasms - surgery; Digestion. Liver. Biliary tract. Spleen. Pancreas; Endoscopy; False Negative Reactions; False Positive Reactions; Fluorodeoxyglucose F18; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Investigative techniques, diagnostic techniques (general aspects); Liver Neoplasms - diagnosis; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Lung Neoplasms - diagnosis; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - secondary; Lung Neoplasms - surgery; Magnetic Resonance Imaging; Medical sciences; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - surgery; Neoplasm Staging; Patient Selection; Radionuclide Imaging; Radionuclide investigations; Radiopharmaceuticals; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tomography, X-Ray Computed; Tumors; Whole-Body Counting; Colonic disease; Human; Relapse; Rectal disease; Prognosis; Stage classification; Rectum; Digestive diseases; Intestinal disease; Colon; Malignant tumor; Positron emission tomography
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-002-0802-9

Whole-body fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has proved effective in the diagnosis and staging of recurrent colorectal cancer. In this study, we analysed how PET affects the management of patients with recurrent colorectal cancer by permitting more accurate selection of candidates for curative resection. The data of 79 patients with known or suspected recurrent colorectal cancer were analysed. Conventional imaging modalities (CIM) and PET results were compared with regard to their accuracy in determining the extent and the resectability of tumour recurrence. Recurrence was demonstrated in 68 of the 79 patients. The data indicate that PET was superior to CIM for detection of recurrence at all sites except the liver. Based on the CIM+PET staging, surgery with curative intent was proposed in 39 patients and was indeed achieved in 31 of them (80%). PET was more accurate than CIM alone in predicting the resectability or non-resectability of the recurrence (82% vs 68%, P=0.02). It is concluded that whole-body FDG-PET is highly sensitive for both the diagnosis and the staging of patients with recurrent colorectal cancer. Its use in conjunction with conventional imaging procedures results in a more accurate selection of patients for surgical treatment with curative intent.