Fluorine-18 fluorodeoxyglucose PET in the preoperative staging of colorectal cancer

Elvira, J.M. Llamas; Rodrı́guez-Fernández, Antonio; Gutiérrez-Sáinz, Javier; Gómez-Río, Manuel; Bellon-Guardia, Maria; Ramos-Font, C.; Rebollo-Aguirre, Á.C.; Cabello-García, D.; Ferrón-Orihuela, Antonio

doi:10.1007/s00259-006-0274-4

Cited by 97 publications

(48 citation statements)

References 22 publications

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“…Quellen: [410] Starker Konsens Die Sensitivität der PET für Fernmetastasen war hoch (75 -100 %) und in einigen Fällen den Vergleichsmethoden überlegen [656,661], in anderen Fällen nicht überlegen [657 -659, 664]. Unklar ist die Qualität der Vergleichsmethoden.…”

Section: Level Of Evidenceunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

147

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Section: Level Of Evidenceunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

147

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“…Kolorektal kanser (KRK) tüm dünyada yaygın ve ölümcül bir hastalıktır ve kansere bağlı ölüm nedenleri arasında 3. sırada gelmektedir (1). Cerrahi rezeksiyon tedavinin temelini oluşturur, ancak tedavinin başarısında tümörün tanı anındaki yayılımı oldukça belirleyicidir (2).…”

Section: Introductionunclassified

The Impact Of Fdg-pet For The Preoperative Management Of Patients With Colorectal Cancer.

Kılbaş¹,

Yiğit²,

Ilgan³

et al. 2009

TUTFD

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Original Article ÖZETAmaç: Tüm vücut fl uorodeoksiglukoz pozitron emisyon tomografi (FDG-PET) görüntülemenin rekürren kolorektal kanser (KRK) tanısındaki ve kanser tedavisine yanıtın takibindeki rolü kanıtlanmıştır. Fakat KRK'in FDG-PET ile preoperatif değerlendirilmesinin tedavi seçimine katkısı ile ilgili az sayıda çalışma mevcuttur. Bu çalışmada FDG-PET'in KRK'li hastalarda, preoperatif dönemde, hasta yönetimine katkısını araştırdık. Gereç ve Yöntemler:Bu prospektif çalışmaya, histopatolojik veya yük-sek klinik şüphe ile KRK tanısı almış, 26 ardışık hasta (16 erkek, 10 kadın) dahil edildi. Tüm hastalar bilgisayarlı tomografi (BT) ve FDG-PET ile değerlendirildi. Histopatolojik veya klinik takip bulguları esas alınarak FDG-PET sonuçları BT sonuçları ile karşılaştırıldı.Bulgular: FDG-PET primer kanseri saptamada %96 duyarlılığa ve %100 pozitif öngörü değerine sahipken BT'de bu değerler sırasıyla %68 ve %95 idi. FDG-PET ilave metastatik hastalığı saptamada %89 duyarlılık ile BT'ye (%33) üstünlük göstermekteydi. FDG-PET 8 hastanın tedavi seçiminde değişikliğe neden olarak olumlu katkı yaptı, bunlardan 3'ünde gereksiz cerrahiden kaçınılmış oldu.Sonuç: FDG-PET'in KRK'in tanısında ve evrelemesinde yüksek duyarlılık gösterdiği sonucuna varılmıştır. BT ile birlikte kullanımı küratif amaçlı cerrahi işlem planlanan hastaların daha doğru şekilde seçilmelerine olanak sağlar. Anahtar Sözcükler: Kolorektal kanser, FDG-PET, hasta yönetimiGeliş tarihi: 25.05.2009 Kabul tarihi: 06.11.2009 ABSTRACT Objective: Whole-body fl uorodeoxyglucose-positron emission tomography (FDG-PET) has proved effective in the diagnosis of recurrent colorectal cancer (CRC) and in the monitoring of cancer therapy. However there have been limited studies considering the effect of FDG-PET in the initial evaluation of CRC. We analysed how FDG-PET affects the management of patients with CRC preoperatively. Material and Methods:A prospective study of 26 consecutive patients with known or suspected CRC was undertaken. The patients were evaluated by computed tomography (CT) and FDG-PET. FDG-PET results were compared with those of CT and correlated with histopathologic fi ndings or with clinical course.Results: FDG-PET had a sensitivity of 96% and positive predictive value of 100% for the diagnosis of primary cancer, while CT had values of 68% and 95%, respectively. FDG-PET was superior to CT in detecting additional metastatic disease with a sensitivity of 89%, while CT had 33%. FDG-PET resulted in altered management for 8 patients of whom three avoided inappropriate surgery. Conclusion:It is concluded that FDG-PET is highly sensitive for the diagnosis and staging of patients with CRC. Its use in conjunction with CT results in a more accurate selection of patients for surgical treatment with curative intent. GirişKolorektal kanser (KRK) tüm dünyada yaygın ve ölümcül bir hastalıktır ve kansere bağlı ölüm nedenleri arasında 3. sırada gelmektedir (1). Cerrahi rezeksiyon tedavinin temelini oluşturur, ancak tedavinin başarısında tümörün tanı anındaki yayılım...

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“…Additionally, there is a higher frequency of micrometastasis involving nodes of normal size in patients with rectal cancer (7). Similarly, 18 F-FDG PET/CT has limited sensitivity for the detection of nodal disease due to small size of nodes, variable 18 F-FDG uptake, and higher 18 F-FDG uptake in adjacent structures including the bladder and sometimes physiologic uptake in the bowel (8). The assessment of 18 F-FDG PET/CT images can also be problematic in patients presenting with suspected recurrent disease after surgical management.…”

mentioning

confidence: 98%

Characterization of a Perirectal Artifact in ¹⁸F-FDG PET/CT

Lodge¹,

Chaudhry²,

Udall³

et al. 2010

J Nucl Med

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Assessing tumor involvement in the rectal region can sometimes be complicated by what appears to be an artifact on 18 F-FDG PET/CT images. This artifact manifests as a highintensity region on the PET image, extending posterior to the bladder in the area around the rectum. The aim of this study was to describe this artifact, which-as far as we are awarehas not been previously reported, and to investigate its cause. Methods: One hundred 18 F-FDG PET/CT studies (orderedsubsets expectation maximization reconstruction, CT attenuation correction) of patients with no known malignancy in the pelvis were retrospectively reviewed. Localized regions of apparently high uptake posterior to the bladder were considered an artifact when there was a discrepancy between attenuation-corrected (asymmetric appearance) and nonattenuation-corrected images (symmetric appearance). In addition, an experiment was performed using a body phantom containing 2 cylindric inserts simulating the bladder and a region of low-attenuation rectal gas. Attenuation-corrected images were reconstructed with different amounts of spatial misregistration intentionally introduced between the CT and PET images. Results: The artifact was observed in 15 of 100 patient studies and had a mean maximum standardized uptake value of 4.8 6 2.7. When fused with sequentially acquired CT images, the artifact always appeared to be in the perirectal region near the bladder and an area of rectal gas. The phantom study indicated this artifact was consistent with an attenuation-correction problem caused by misregistration between CT and PET. Movement of gas within the rectum can cause an air pocket to be present during the PET acquisition at a location where CT indicated soft tissue. The resulting localized overcorrection for attenuation at the margin of the rectum and the extremely high activity concentration in the nearby bladder contributed to the artifact. Conclusion: Movement of gas within the rectum between acquisition of CT and PET images can lead to an artifact in attenuation-corrected PET images in the perirectal region. An awareness of this artifact and reference to non-attenuation-corrected images will aid in the interpretation of 18 F-FDG pelvis studies.

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Fluorine-18 fluorodeoxyglucose PET in the preoperative staging of colorectal cancer

Abstract: Compared with conventional techniques, FDG-PET appears to be useful in pre-surgical staging of CC, revealing unsuspected disease and impacting on the treatment approach.

Cited by 97 publications

References 22 publications

S3-Leitlinie – Kolorektales Karzinom

S3-Leitlinie – Kolorektales Karzinom

The Impact Of Fdg-pet For The Preoperative Management Of Patients With Colorectal Cancer.

Characterization of a Perirectal Artifact in ¹⁸F-FDG PET/CT

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Fluorine-18 fluorodeoxyglucose PET in the preoperative staging of colorectal cancer

Abstract: Compared with conventional techniques, FDG-PET appears to be useful in pre-surgical staging of CC, revealing unsuspected disease and impacting on the treatment approach.

Cited by 97 publications

References 22 publications

S3-Leitlinie – Kolorektales Karzinom

S3-Leitlinie – Kolorektales Karzinom

The Impact Of Fdg-pet For The Preoperative Management Of Patients With Colorectal Cancer.

Characterization of a Perirectal Artifact in 18F-FDG PET/CT

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Characterization of a Perirectal Artifact in ¹⁸F-FDG PET/CT