Dis Colon Rectum 2000 Jun;43(6):759-67; discussion 767-70
Usefulness of FDG-PET scan in the assessment of suspected metastatic or
recurrent adenocarcinoma of the colon and rectum.
Whiteford MH, Whiteford HM, Yee LF, Ogunbiyi OA, Dehdashti F, Siegel BA,
Birnbaum EH, Fleshman JW, Kodner IJ, Read TE.
PURPOSE: The purpose of this study was to evaluate the clinical efficacy of
positron emission tomography with 2-[18F] fluoro-2-deoxy-D-glucose compared with
computed tomography plus other conventional diagnostic studies in patients
suspected of having metastatic or recurrent colorectal adenocarcinoma. METHODS:
The records of 105 patients who underwent 101 computed tomography and 109
2-[18F] 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, histopathologically, or
by clinical course. RESULTS: The overall sensitivity and specificity of 2-[18F]
fluoro-2-deoxy-D-glucose positron emission tomography in detection of clinically
relevant tumor were higher (87 and 68 percent) than for computed tomography plus
other conventional diagnostic studies (66 and 59 percent). The sensitivity of
2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in detecting
mucinous cancer was lower (58 percent; n = 16) than for nonmucinous cancer (92
percent; n = 93). The sensitivity of 2-[18F] fluoro-2-deoxy-D-glucose positron
emission tomography in detecting locoregional recurrence (n = 70) was higher
than for computed tomography plus colonoscopy (90 vs. 71 percent, respectively).
The sensitivity of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography
in detecting hepatic metastasis (n = 101) was higher than for computed
tomography (89 vs. 71 percent). The sensitivity of 2-[18F]
fluoro-2-deoxy-D-glucose positron emission tomography in detecting extrahepatic
metastases exclusive of locoregional recurrence (n = 101) was higher than for
computed tomography plus other conventional diagnostic studies (94 vs. 67
percent). 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography altered
clinical management in a beneficial manner in 26 percent of cases (26/101) when
compared with evaluation by computed tomography plus other conventional
diagnostic studies. CONCLUSION: 2-[18F] fluoro-2-deoxy-D-glucose positron
emission tomography is more sensitive than computed tomography for the detection
of metastatic or recurrent colorectal cancer and may improve clinical management
in one-quarter of cases. However, 2-[18F] fluoro-2-deoxy-D-glucose positron
emission tomography is not as sensitive in detecting mucinous adenocarcinoma,
possibly because of the relative hypocellularity of these tumors.
