Preoperative PET/CT ¹⁸F-FDG Standardized Uptake by Lymph Nodes as a Significant Prognostic Factor in Patients with Colorectal Cancer

Abstract

Purpose We evaluated the prognostic value of preoperative 18F-FDG uptake by suspected lymph nodes (LNs) using 18F-FDG PET/CT in colorectal cancer patients. Methods Patients with CRC underwent 18F-FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the 18F-FDG maximum standardized uptake value (SUVmax) in the suspected LNs (SUVLN) on 18F-FDG PET/CT. Results Clinical data, treatment modalities, and results from 90 CR C patients were reviewed. The median follow-up was 19 months (range 3 to 72 months). Receiver operating characteristic analysis identified SUVLN 1.15 was the optimal cut-off value for predicting recurrence. SUVLN correlated with tumour size (P=0.045), lymph node metastasis (P=0.03), and recurrence (P < 0.0001). Univariate analysis showed significant associations between recurrence and SUVLN (P=0.017), and tumour grade (P=0.013). Multivariate analysis identified SUVLN (P < 0.0001), and tumour grade (P=0.005) as independent risk factors for recurrence. Patients with SUVLN ≤ 1.15 and SUVLN > 0.15 differed significantly in terms of recurrence (P < 0.0001). Conclusion Preoperative SUVLN measured by 18F-FDG PET/CT was significantly associated with recurrence and had significant prognostic value for recurrence-free survival in patients with colorectal cancer.

Efficacy of Positron Emission Tomography in Diagnosis of Lateral Lymph Node Metastases in Patients with Rectal Cancer: A retrospective study

“…Several studies on the prediction of lymph node metastases in patients with colorectal or rectal cancers have been conducted, in which the cutoff value of SUVmax was set within the range of 1.15-2.5 [22][23][24][25]. Although the present study focused only on the LLN, no signi cant difference was observed in the cutoff values when comparing the results of our study with those of other studies.…”

Is 18F-FDG PET/CT an Accurate Way to Detect Lymph Node Metastasis in Colorectal Cancer: A Systematic Review and Meta-Analysis

“…Forest plots of the pooled sensitivity and specificity are demonstrated in Figure 3 . A comparison between malignant and benign LNMs from 13 eligible studies [ 15 , 18 , 29 – 38 ] determined that the pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio with corresponding 95% confidence intervals (CI) were 0.65 (95% CI 0.63–0.68), 0.75 (95% CI 0.73–0.78), 4.57 (95% CI 2.84–7.35), and 0.37 (95% CI 0.28–0.48), respectively. The DOR with the corresponding 95% confidence intervals was 18.00 (95% CI 7.84–41.32) ( Figure 4(a) ).…”

68Ga-FAPI improves tumor staging in patients with colorectal cancer: comparing to 18F-FDG PET/CT

“…The superiority of 18 F-FDG PET/CT in CRC is evident in the detection of lymph nodes and distant metastases and the detection of additional metastases can signi cantly change treatment plans [23][24][25]. However, several studies showed that the detection of metastatic regional nodes was low/moderate using 18 F-FDG PET/CT, demonstrating the limitations of this method [26,27].…”