The clinical impact of camera-based positron emission tomography imaging in patients with recurrent colorectal cancer.

نویسندگان

  • Elka Miller
  • Hedva Lerman
  • Mordechai Gutman
  • Arie Figer
  • Genady Livshitz
  • Einat Even-Sapir
چکیده

RATIONALE AND OBJECTIVES F18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) studies have clinical value in suspected recurrent or metastatic colorectal cancer cases. Because this modality is not accessible for many patients, a camera-based FDG (CB-FDG) coincidence imaging was suggested as an alternative. Although inferior in resolution to a dedicated PET system, it can make FDG studies available to more patients. We assessed the clinical value of CB-FDG in patients with recurrent colorectal cancer. METHODS The disease stage and treatment approach in 83 patients were twice determined by an oncologist and a surgeon, first based on the patient's records and blind to CB-FDG findings and then with the inclusion of FDG results in the decision-making analysis. RESULTS On a lesion-based analysis, the sensitivity of CB-FDG was 95% and the specificity was 81% compared with 88% and 64%, respectively, for computed tomography. Adding FDG findings led to disease-stage alteration in 47 patients (57%), upstaging in 35 (42%), and downstaging in 12 (15%). FDG localized the tumor sites in 21 of 26 patients (81%) with suspected clinical recurrence and a negative conventional imaging workup. In 8 patients, FDG ruled out viable tumor tissue suggested by other modalities. The oncologist's suggested treatment approach was altered in 54% of the patients and the surgeon altered the decision on operability in 28%. CONCLUSION CB-FDG assessment has clinical value for both staging and selecting treatment in patients with recurrent colorectal cancer and can be considered an alternative to an nonaccessible dedicated PET system.

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عنوان ژورنال:
  • Investigative radiology

دوره 39 1  شماره 

صفحات  -

تاریخ انتشار 2004