Detection of recurrent and metastatic colorectal cancer: Comparison of positron emission tomography and computed tomography

Ogunbiyi, Olagunju; Flanagan, Fidelma; Dehdashti, Farrokh; Siegel, Barry A.; Trask, D D; Birnbaum, Elisa H.; Fleshman, James W.; Read, Thomas E.; Philpott, Gordon W.; Kodner, Ira J.

doi:10.1007/bf02303744

Cited by 252 publications

(92 citation statements)

References 31 publications

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“…18 F-FDG PET/CT has been proven to be a meaningful diagnostic modality in the management of various cancers, with accuracy in the detection of recurrence and treatment response evaluation in patients with CRC and other types of tumors, such as s ovarian cancer, and Hodgkin and non-Hodgkin lymphomas (15)(16)(17). It has been shown that PET has higher sensitivity as compared with CT in the detection of abdominal and extra-abdominal metastatic sites (17).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of recurrent disease in the re-staging of colorectal cancer by 18F-FDG PET/CT: Use of CEA and CA 19–9 in patient selection

et al. 2016

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Abstract. The aim of the present retrospective study was to evaluate the sensitivity and specificity of fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing the recurrence of colorectal cancer (CRC) with regard to carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9). 18 F-FDG PET/CT was performed in 100 patients for the re-staging of CRC. Therapy was discontinued prior to the examination. The mean (± standard deviation) CEA value (measured ~30 days prior to PET/CT examination) was 23.71 (±107) ng/ml, whereas the CA 19-9 value was 72 (±190.3) U/ml. Differences in CEA and CA 19-9 values in patients with scans that were positive or negative for recurrence were analyzed by means of a receiver operating characteristic (ROC) curve. ROC curves were used for the calculation of the sensitivity and specificity of 18 F-FDG PET/CT for the CEA and CA 19-9 levels. The results of the 18 F-FDG PET/CT were found to be associated with the CEA level (P= 0.001), but not with the CA 19-9 level (P= 0.43). PET/CT was positive for recurrence in 60 patients (60.0%), whose mean CEA and CA 19-9 values were 33.07±136.7 ng/ml and 75.24±192.3 U/ml, respectively. PET/CT was negative for recurrence in 40 patients (40.0%), whose mean CEA and CA 19-9 values were 10.15±30 ng/ml and 67.76±190 U/ml, respectively. On the basis of ROC curve analysis, the best compromise between sensitivity and specificity was achieved for CEA levels of 3.5 ng/ml [sensitivity, 80%; 95% confidence interval (CI), 67-89%; and specificity, 60%; 95% CI, 45-78%]. The study concluded that the detection of recurrence by 18 F-FDG PET/CT in patients treated for CRC is associated with CEA, but not CA 19-9 serum levels. Moreover, 18 F-FDG PET/CT should be recommended in patients with suspected CRC recurrence even when they present with CEA levels below the normal cut-off.

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Section: Discussionmentioning

confidence: 99%

Evaluation of recurrent disease in the re-staging of colorectal cancer by 18F-FDG PET/CT: Use of CEA and CA 19–9 in patient selection

et al. 2016

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“…En los pacientes tratados de una neoplasia colorectal, con la sospecha de recurrencia basada en la elevación sérica del antígeno carcinoembrionario, el cambio de manejo terapéutico provocado por la PET es del 39% y no difiere de los resultados previamente obtenidos por Vitola 20 (25%), Lai 21 (29%), Delbeke 22 (33%), Ogunbiyi 23 (44%) o Valk 24 (31%). Este cambio de actitud terapéutica se explica por una una mayor sensibilidad de la PET con respecto a la TAC en la valoración de la infiltración tumoral del abdomen, la pelvis y el retroperitoneo, así como por su capacidad de detectar enfermedad tumoral en localizaciones pocos habituales (mediastino, hueso y glándulas suprarrenales) 24 .…”

Section: Discussionunclassified

Impacto clínico de la PET con 18FDG en la selección de la terapia de los pacientes oncológicos

et al. 2006

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ResumenObjetivo: Determinar el impacto clínico de la PET en la actitud terapéutica de los pacientes oncológicos. Material y métodos:Hemos incluido en este trabajo los cien primeros estudios oncológicos consecutivos de PET con 18 FDG de cuerpo completo (75 varones/22 mujeres, edad media de 67 años) procedentes de un mismo hospital público de nuestra comunidad. El impacto de la PET se calculó mediante los resultados de una encuesta enviada a cada uno de los médicos solicitantes de la prueba. Este cuestionario se diseñó fundamentalmente para valorar el tipo de cambio de tratamiento (intramodalidad/intermodalidad) ocasionado tras los hallazgos de la PET.Resultados: Las tres neoplasias estudiadas más frecuentes fueron: carcinoma broncogénico (34%), neoplasia colo-rectal (24%) y nódulo pulmonar solitario (15%). La PET cambió la actitud terapéutica inicialmente prevista en 53 (55%) de los 97 casos evaluados (tipo intramodalidad en 5 e intermodalidad en 48). Diecisiete pacientes (17.5%) candidatos a cirugía curativa fueron finalmente tratados con un tratamiento sistémico de quimioterapia con o sin radioterapia. Los médicos encuestados consideraron que la PET constituía una herramienta diagnóstica útil en el 69% de los casos y que evitaba maniobras diagnósticas agresivas en 56%.Conclusión: En nuestra serie de pacientes, la PET con FDG ha sido una herramienta diagnóstica de gran utilidad. Mejora la estadificación inicial de las neoplasias, en especial del carcinoma broncogénico y estadifica de forma más precisa la recidiva tumoral de diferentes tipos de tumores, especialmente de la neoplasia colo-rectal. De este modo, la PET ayuda a seleccionar el tratamiento óptimo en cada caso, evitando cirugías innecesarias.

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“…The residual pelvic soft tissue abnormalities frequently seen in the tumor bed region after therapy usually complicate the detection of local recurrence by the conventional imaging techniques 1314. Abnormal 18 F-FDG activity in a residual pelvic soft tissue lesion after 6 months from the completion of radiotherapy most likely represents tumor recurrence, and accuracy and positive predictive value (PPV) are even higher after 12 months 111516.…”

Section: Methodsmentioning

confidence: 99%

¹⁸F-FDG PET/CT Imaging In Oncology

Almuhaideb

Παπαθανασίου

Bomanji

2011

Annals of Saudi Medicine

273

123

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Accurate diagnosis and staging are essential for the optimal management of cancer patients. Positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) has emerged as a powerful imaging tool for the detection of various cancers. The combined acquisition of PET and CT has synergistic advantages over PET or CT alone and minimizes their individual limitations. It is a valuable tool for staging and restaging of some tumors and has an important role in the detection of recurrence in asymptomatic patients with rising tumor marker levels and patients with negative or equivocal findings on conventional imaging techniques. It also allows for monitoring response to therapy and permitting timely modification of therapeutic regimens. In about 27% of the patients, the course of managment is changed. This review provides guidance for oncologists/ radiotherapists and clinical and surgical specialists on the use of 18F-FDG PET/CT in oncology.

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Detection of recurrent and metastatic colorectal cancer: Comparison of positron emission tomography and computed tomography

Abstract: FDG-PET is more sensitive than CT in the clinical assessment of patients with recurrent or metastatic CRC, and provides an accurate means of selecting appropriate treatment for these patients.

Cited by 252 publications

References 31 publications

Evaluation of recurrent disease in the re-staging of colorectal cancer by 18F-FDG PET/CT: Use of CEA and CA 19–9 in patient selection

Evaluation of recurrent disease in the re-staging of colorectal cancer by 18F-FDG PET/CT: Use of CEA and CA 19–9 in patient selection

Impacto clínico de la PET con 18FDG en la selección de la terapia de los pacientes oncológicos

¹⁸F-FDG PET/CT Imaging In Oncology

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Detection of recurrent and metastatic colorectal cancer: Comparison of positron emission tomography and computed tomography

Abstract: FDG-PET is more sensitive than CT in the clinical assessment of patients with recurrent or metastatic CRC, and provides an accurate means of selecting appropriate treatment for these patients.

Cited by 252 publications

References 31 publications

Evaluation of recurrent disease in the re-staging of colorectal cancer by 18F-FDG PET/CT: Use of CEA and CA 19–9 in patient selection

Evaluation of recurrent disease in the re-staging of colorectal cancer by 18F-FDG PET/CT: Use of CEA and CA 19–9 in patient selection

Impacto clínico de la PET con 18FDG en la selección de la terapia de los pacientes oncológicos

18F-FDG PET/CT Imaging In Oncology

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¹⁸F-FDG PET/CT Imaging In Oncology