Ann Coloproctol.  2014 Dec;30(6):259-265. 10.3393/ac.2014.30.6.259.

Reliability of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Nodal Staging of Colorectal Cancer Patients

• Yi HJ
• Hong KS
• Moon N
• Chung SS
• Lee RA
• Kim KH

• KMID: 1882734
• DOI: http://doi.org/10.3393/ac.2014.30.6.259

Abstract

PURPOSE
Lymph-node metastasis is considered as critical prognostic factor in colorectal cancer. A preoperative evaluation of lymph-node metastasis can also help to determine the range of distant lymph node dissection. However, the reliability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of lymph-node metastasis is not fully known.
METHODS
The medical records of 433 patients diagnosed with colorectal cancer were reviewed retrospectively. FDG-PET/CT and CT were performed on all patients. Lymph nodes were classified into regional and distant lymph nodes according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th edition.
RESULTS
The patients included 231 males (53.3%) and 202 females (46.7%), with a mean age of 64.7 +/- 19.0 years. For regional lymph nodes, the sensitivity of FDG-PET/CT was lower than that of CT (57.1% vs. 73.5%, P < 0.001). For distant lymph nodes, the sensitivity of FDG-PET/CT was higher than that of CT (64.7% vs. 52.9%, P = 0.012). The sensitivity of FDG-PET/CT for regional lymph nodes was higher in patients with larger primary tumors. The positivity of lymph-node metastasis for FDG-PET/CT was affected by carcinoembryonic antigen levels, tumor location, and cancer stage for regional lymph nodes and by age and cancer stage for distant lymph nodes (P < 0.05).
CONCLUSION
The sensitivity of FDG-PET/CT for regional lymph-node metastasis was not superior to that of CT. However, FDG-PET/CT provides helpful information for determining surgical plan especially in high risk patients group.

Keyword

Colorectal neoplasms; Positron emission tomography; Lymph node; Metastasis

MeSH Terms

Carcinoembryonic Antigen
Colorectal Neoplasms*
Electrons*
Female
Humans
Joints
Lymph Node Excision
Lymph Nodes
Male
Medical Records
Neoplasm Metastasis
Neoplasm Staging
Positron-Emission Tomography
Retrospective Studies
Carcinoembryonic Antigen