Details

Autor(en) / Beteiligte

• Miller, Elka
• Lerman, Hedva
• Gutman, Mordechai
• Figer, Arie
• Livshitz, Genady
• Even-Sapir, Einat

Titel

The Clinical Impact of Camera-Based Positron Emission Tomography Imaging in Patients With Recurrent Colorectal Cancer

Ist Teil von

• Investigative radiology, 2004-01, Vol.39 (1), p.8-12

Ort / Verlag

United States: Lippincott Williams & Wilkins, Inc

Erscheinungsjahr

2004

Quelle

MEDLINE

Beschreibungen/Notizen

• RATIONALE AND OBJECTIVESF18-fluorodeoxyglucose (FDG)–positron emission tomography (PET) studies have clinical value in suspected recurrent or metastatic colorectal cancer cases. Because this modality is not accessible for many patients, a camera-based FDG (CB-FDG) coincidence imaging was suggested as an alternative. Although inferior in resolution to a dedicated PET system, it can make FDG studies available to more patients. We assessed the clinical value of CB-FDG in patients with recurrent colorectal cancer. METHODSThe disease stage and treatment approach in 83 patients were twice determined by an oncologist and a surgeon, first based on the patient’s records and blind to CB-FDG findings and then with the inclusion of FDG results in the decision-making analysis. RESULTSOn a lesion-based analysis, the sensitivity of CB-FDG was 95% and the specificity was 81% compared with 88% and 64%, respectively, for computed tomography. Adding FDG findings led to disease-stage alteration in 47 patients (57%), upstaging in 35 (42%), and downstaging in 12 (15%). FDG localized the tumor sites in 21 of 26 patients (81%) with suspected clinical recurrence and a negative conventional imaging workup. In 8 patients, FDG ruled out viable tumor tissue suggested by other modalities. The oncologist’s suggested treatment approach was altered in 54% of the patients and the surgeon altered the decision on operability in 28%. CONCLUSIONCB-FDG assessment has clinical value for both staging and selecting treatment in patients with recurrent colorectal cancer and can be considered an alternative to an nonaccessible dedicated PET system.