engleski

Fluorodeoxyglucose wole-body positron emission tomography in evaluation of recurrent and metastatic colorectal cancer patients

Introduction: Surgery remains the only option for potential cure in patients with recurrent colorectal cancer. Accurate staging modalities aid in the avoidance of futile surgery, which may result in considerable morbidity in patients with incurable disease. Current imaging techniques, used in disease staging, often are not sensitive enough to identify low-volume metastatic disease. This study reviews the role of positron emission tomography in the assessment of patients with suspected recurrent colorectal cancer. To evaluate the routine clinical value of attenuation- corrected whole-body fluorodeoxyglucose positron emission tomography in recurrent colorectal cancer, a total of 36 patients, who were referred for evaluation of suspected or proven local recurrence or metastases of colorectal cancers were studied. Methods: The records of 36 patients, who underwent 35 computed tomography, and 36 2- [l8F]-fluoro-2-deoxy-D-glucose positron emission tomography scans for suspected metastatic or recurrent colorectal adenocarcinoma, were reviewed. Clinical correlation was confirmed at time of operation, histopathologicaly, or by clinical course. Results: Recurrence was correctly classified as true-negative in 20 cases. Local recurrence was found to be true-positive in 12 patients and false positive in one patient. Recurrence in the pelvic area was detected in 7 patients. Three of those patients were reoperated with intention for cure. Smallest lesion that was positively detected by PET was 2 cm in size. Presence of vital tumor tissue in liver metastases could be demonstrated as true-positive in 22 patients, and were false-positive in two patients. Comment: Local recurrence following curative resection for colorectal cancer occurs in 10-30 per cent of patients. The early detection of local pelvic recurrence has been emphasized, because a favorable survival rate may be obtained by extended radical operations such as a total pelvic exenteration combined with sacral resection. Better specificity and sensitivity of FDG-PET over CT showed in our results in detecting recurrence in pelvic region and liver will enable us to perform operations in a smaller recurrent disease, and that will contribute to better survival. PET- CT is investigation with even better specificity and sensitivity and its implementation in diagnostics of rectal carcinoma recurrence is expected.

positron-emission tomography ; 18fluorodeoxyglucose ; colorectal neoplasms

Abstract of the Scientific Syposium with International Participation "40 Years of Nuclear Medicine in Osijek", November 15 - 17, 2007. Osijek, Croatia.