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Is 18F-FDG PET/CT Useful for Imaging and Management of Patients with Suspected Occult Recurrence of Cancer?

Ora Israel, MD1,2, Maya Mor, MD1, Luda Guralnik, MD3, Nirit Hermoni, MD1, Diana Gaitini, MD2,3, Rachel Bar-Shalom, MD1, Zohar Keidar, MD, PhD1,2 and Ron Epelbaum, MD2,4

1 Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel
2 The B. Rappaport School of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
3 Department of Diagnostic Imaging, Rambam Medical Center, Haifa, Israel
4 Department of Oncology, Rambam Medical Center, Haifa, Israel



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  		FIGURE 1. An 81-y-old man with cancer of sigmoid colon, after surgery, increasing carcinoembryonic antigen (CEA) serum levels, and a repeated negative CT study. (A) PET shows focal area of increased 18F-FDG uptake in right upper abdomen. (B) Hybrid PET/CT images precisely localized this uptake to colon, consistent with physiologic bowel excretion. Malignancy was excluded and study was reported as normal. Patient had no evidence of recurrence in colon during 15 mo of clinical follow-up.

 


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  		FIGURE 2. A 52-y-old man with colon cancer, after surgery, increasing carcinoembryonic antigen (CEA) serum levels, and a repeated negative CT study. (A) PET shows focal area of abnormal 18F-FDG uptake in left upper abdomen, suggestive of recurrence. (B) Hybrid PET/CT images precisely localized this uptake anterior to tail of pancreas, medial to spleen. Retrospective evaluation of CT performed 2 mo earlier and examination of CT study performed simultaneously with PET did not reveal any abnormalities. Surgeons used location provided by PET/CT for reexploration of abdomen and recurrent tumor in colon was found.

 




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