Patient And Lesion-Based Analysis Of 18F-FDG PET/CT Compared With Conventional CT During Follow Up of Patients With Colorectal Carcinoma | ||||
| Egyptian Journal Nuclear Medicine | ||||
| Article 5, Volume 8, Issue 8, December 2013, Page 45-54 PDF (428.51 K) | ||||
| Document Type: Original Paper, Oncology | ||||
| DOI: 10.21608/egyjnm.2013.5459 | ||||
 View on SCiNiTO | ||||
| Author | ||||
jehan ahmed younis 
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| department of Oncology and Nuclear medicine, faculty of medicine, Cairo university, Cairo, Egypt | ||||
| Abstract | ||||
| Objective: The aim of this study was to evaluate the potential significance of 18FFDG PET/CT in detection of local or distant disease recurrence during routine follow up of patients with colorectal cancer (CRC) in comparison with conventional CT. Methods: Sixty seven patients (43 males and 24 females; age range 32-72 years, mean 55.7±9.2 years) with histologically proven CRC previously treated by surgery and chemotherapy. 18FFDG PET/CT and conventional CT were performed for all patients. Diagnostic ability was determined on a patient and on a lesion site basis (loco-regional recurrence, hepatic or extra-hepatic metastases that include LNs, bone and other sites). The final diagnosis was obtained from the results of histopathological examination after surgery or biopsy, or follow-up after at least 6-12 months on the basis of clinico-radiologic or follow up PET/CT. Results: On patientbasis analysis, PET/CT showed higher sensitivity, specificity and accuracy than CT in detection of local recurrence and metastatic lesions (94.6%, 100%, and 95.5% for PET/CT versus 83.9 %, 100% and 86.6% for diagnostic CT, respectively). On lesion-basis analysis, loco-regional recurrence was present in 23 patients, PET/CT detected all 25 lesions (100%) compared to 14/25 lesions (56%) detected by CT. Twenty-six Liver metastatic lesions were detected in 12 patients, PET/CT and CT accurately detected 22/26 (84.6%) and 21/26 (80.7%) hepatic lesions, respectively. PET/CT identified 32/42 LNs (76%) versus 23/42 LNs (55%) identified by CT in 19 patients. PET/CT had higher detectability of bone deposits than CT. PET/CT definitely changed the treatment modality in 28/67 patients (41.8%). PET/CT showed recurrent disease in 5/18 patients with elevated carcino-embryonic antigen who had negative CT. Conclusion: 18F-FDG PET/CT provides high accuracy for detection of recurrent and distant metastases than conventional CT in CRC patients during regular follow up. PET/CT changed the management strategy in a significant number of patients on lesion-based analysis. The use of 18F-FDG PET/CT in the regular follow up of CRC patients is worth considering. | ||||
| Keywords | ||||
| colorectal cancer; lesion-basis analysis; CT; 18F-FDG PET/CT | ||||
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