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Value of Surveillance 18F-FDG PET/CT in Colorectal Cancer: Comparison with Conventional Imaging Studies

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Abstract

Purpose

To assess the value of PET/CT for detecting local or distant recurrence in patients who undergo surgery for colorectal cancer (CRC) and to compare the accuracy of PET/CT to that of conventional imaging studies (CIS).

Methods

Tumor surveillance PET/CT scans done between March 2005 and December 2009 of disease-free patients after surgery with or without adjuvant chemotherapy for CRC were retrospectively studied. CIS (serial enhanced CT from lung base to pelvis and plain chest radiograph) were performed within 1 month of PET/CT. We excluded patients with distant metastasis on initial staging, a known recurrent tumor, and a lack of follow-up imaging. The final diagnosis was based on at least 6 months of follow-up with colonoscopy, biopsy, and serial imaging studies in combination with carcinoembryonic antigen levels.

Results

A total of 262 PET/CT scans of 245 patients were included. Local and distant recurrences were detected in 27 cases (10.3%). On case-based analysis, the overall sensitivity, specificity, and accuracy were 100, 97.0, and 97.3% for PET/CT and 85.1, 97.0, and 95.8% for CIS, respectively. On lesion-based analysis, PET/CT detected more lesions compared to CIS in local recurrence and lung metastasis. PET/CT and CIS detected the same number of lesions in abdominal lymph nodes, hepatic metastasis, and peritoneal carcinomatosis. PET/CT detected two more metachronous tumors than did CIS in the lung and thyroid gland.

Conclusion

PET/CT detected more recurrences in patients who underwent surgery for CRC than did CIS and had the additional advantage of evaluating the entire body during a single scan.

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Authors and Affiliations

  1. Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Eun Kyoung Choi, Ie Ryung Yoo, Hye Lim Park, Hyun Su Choi, Eun Ji Han, Sung Hoon Kim & Soo Kyo Chung

  2. Department of Radiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Joo Hyun O

  3. Department of Nuclear Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seochogu Banpodong 505, Seoul, 137-701, Korea

    Ie Ryung Yoo

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  1. Eun Kyoung Choi
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Correspondence to Ie Ryung Yoo.

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Choi, E.K., Yoo, I.R., Park, H.L. et al. Value of Surveillance 18F-FDG PET/CT in Colorectal Cancer: Comparison with Conventional Imaging Studies. Nucl Med Mol Imaging 46, 189–195 (2012). https://doi.org/10.1007/s13139-012-0145-9

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  • DOI: https://doi.org/10.1007/s13139-012-0145-9

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