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Routine ¹⁸F-FDG PET Preoperative Staging of Colorectal Cancer: Comparison with Conventional Staging and Its Impact on Treatment Decision Making

Iva Kantorová, MD¹, Ludmila Lipská, MD², Otakar Bêlohlávek, MD¹, Vladimír Visokai, MD², Miroslav Truba, MD² and Michaela Schneiderová, MD²

¹ PET Centre, Department of Nuclear Medicine, Na Homolce Hospital, Prague, Czech Republic
² Department of Surgery, Thomayer’s Teaching Hospital, Prague, Czech Republic

View larger version (41K): [in a new window]   FIGURE 1. 18F-FDG PET scan of 78-y-old woman with primary rectal carcinoma (solid arrows) and histologically proven metastasis in lymph nodes (dashed arrows). PET findings were true-positive, and CT findings were false-negative. Shortly before PET examination, hypermetabolic focus on surface of right hypogastrium showed inflammatory reactive changes after previous appendectomy.

View larger version (37K): [in a new window]   FIGURE 2. 18F-FDG PET scan of 69-y-old man with liver metastases of CRC revealed by PET (arrows). CT performed before PET had false-negative findings.

View larger version (38K): [in a new window]   FIGURE 3. 18F-FDG PET scan of 63-y-old man with suspected liver metastases found during explorative laparotomy. PET findings were evaluated as positive (arrows), sonographic findings were equivocal, CT was not performed, and histologic examination revealed chronic abscess.

View larger version (37K): [in a new window]   FIGURE 4. 18F-FDG PET scan of 38-y-old woman with known liver metastases (solid arrows) and with pulmonary metastasis (dashed arrows) revealed by PET and subsequently confirmed by CT. Plain chest radiography performed before PET had false-negative findings, which may have been due to retrocardiac localization of lesion.