engleski

Clinical impact of FDG-PET in the detection of recurrent colorectal cancer

Conventional diagnostic imaging used to asses recurrence of colorectal cancer often gives doubtful and unspecific findings. The aim of our study was to compare CT and FDG-PET diagnostic value in the detection of recurrent colorectal cancer subsequent to colonic resection (R0) or rectal amputation. In retrospective study sensitivity and specificity of CT and FDG-PET was analyzed in 24 consecutive patients (8 female, 16 male, mean age 59, 9 years (37-73). Clinical findings were suspicious for: a) hepatic, b)intraabdominal, nonhepatic or c) extraabdominal cancer recurrence. The PET findings were compared with CT obtained within 2 month interval. Histology and clinical/imaging follow-up served as gold standard. Results: Sensitivity, specificity, positive predictive value and negative predictive value for CT were as follows: 58, 82%, 57, 14%, 76, 92%, 36, 36%, and for FDG-PET 81, 25%, 87, 50%, 92, 86% and 70, 00%. False negative CT findings were mostly in extrahepatic (intra or extraabdominal) localizations (5/7). There were three false negative FDG-PET findings (2 intrahepatic and 1 extraabdominal localization). False positive CT findings were found in 3 cases (1 hepatic and 2 extrahepatic localizations). Only one FDG-PET finding was false positive due to postoperative changes after hepatic surgery. Conclusions: Our study demonstrated good sensitivity and specificity of FDG-PET in the detection of colorectal cancer recurrence. Poor CT sensitivity and specificity could be attributed to mainly extrahepatic colorectal carcinoma recurrences in our series. FDG-PET appears to be superior diagnostic technique for the detection of recurrent colorectal cancer, especially in cases of extrahepatic localization of the disease.

PET; colorectal cancer; FDG

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