Positron Emission Tomography for Benign and Malignant Disease

Abstract

Synopsis Functional imaging using radiolabeled probes which specifically bind and accumulate in target tissues has improved the sensitivity and specificity of conventional imaging. Positron Emission Tomography using modified glucose probes (FDG-PET) has demonstrated improved diagnostic accuracy in differentiating benign from malignant lesions in the setting of solitary pulmonary nodules. In addition, FDG-PET has become a useful modality in pre-operative staging of patients with lung cancer and is being tested with many other malignancies for its ability to change patient management. This article provides an overview of the current status of FDG-PET and presents the challenges of moving towards routine use.

Detection of Omental Recurrence of Colorectal Cancer by FDG-PET/CT

“…Luboldt et al reported that FDG-PET/CT provided promising accuracy for colorectal mass detection and that, in all carci-nomas and adenomas with high-grade dysplasia 5 . A review by Visioni and Kim stated that the sen-sitivity and specificity of PET-CT in detecting CRC recurrence were 89-95% and 83-92%, respectively 6 . One of the stud-ies evaluated in that review 7 reported a positive predic-tive value of 96.4% and a negative predictive value of 76.9% for the diagnosis of CRC recurrence by PET-CT.…”

Diagnostics of intrapulmonary metastases from colorectal cancer (literature survey)

“…This is a method for functional imaging, which could be combined with CT or MRI and by this way to improve the diagnostics of malignant diseases based on the pathologic changes in the tissues (47). PET/CT is with a high sensitivity and specificity in diagnosis and treatment of the colorectal cancer in comparison with other diagnostic methods and it is expected in near future it would play main role in this area (1,31,46,47).…”

“…Based on data from A. Visioni and J. Kim (47) in up to 50% from unidentified pulmonary nodes at the end are established to be metastases. In these cases PET/CT has sensitivity and specificity 96% and 83% respectively.…”

“…In these cases PET/CT has sensitivity and specificity 96% and 83% respectively. PPV and NPV have been 84% and 96%, respectively (47). The authors recommend the usage of PET/CT in noninvasive diagnostics of unidentified pulmonary lesions and focus on the fact that NPV is significantly higher over 90%, which could significantly reduce the need of invasive diagnostic procedures in part of the patients (47).…”

“…PPV and NPV have been 84% and 96%, respectively (47). The authors recommend the usage of PET/CT in noninvasive diagnostics of unidentified pulmonary lesions and focus on the fact that NPV is significantly higher over 90%, which could significantly reduce the need of invasive diagnostic procedures in part of the patients (47). The sensitivity and specificity of PET/CT in diagnostics of colorectal carcinoma is respectively between 89-95% and 83-92% (47).…”