Intest Res.  2017 Apr;15(2):208-214. 10.5217/ir.2017.15.2.208.

Diagnostic and prognostic value of preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography for colorectal cancer: comparison with conventional computed tomography

• Lee JY
• Yoon SM
• Kim JT
• Kim KB
• Kim MJ
• Park JG
• Lee TG
• Lee SJ
• Koong SS
• Han JH
• Chae HB
• Park SM
• Youn SJ

• KMID: 2425163
• DOI: http://doi.org/10.5217/ir.2017.15.2.208

Abstract

BACKGROUND/AIMS
¹â¸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been used for preoperative staging of colorectal cancer (CRC). However, the diagnostic accuracy of FDG-PET/CT for detection of lymph node or distant metastasis and its prognostic role have not been well established. We therefore evaluated the diagnostic and prognostic value of FDG-PET/CT in comparison with conventional CT for CRC.
METHODS
We investigated 220 patients who underwent preoperative FDG-PET/CT and CT, followed by curative surgery for CRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET/CT and CT for detection of lymph node metastasis and distant metastasis were evaluated. In addition, we assessed the findings of FDG-PET/CT and CT according to outcomes, including cancer recurrence and cancer-related death, for evaluation of prognostic value.
RESULTS
For detection of lymph node metastasis, FDG-PET/CT had a sensitivity of 44%, a specificity of 84%, and an accuracy of 67%, compared with 59%, 65%, and 62%, respectively, for CT (P=0.029, P=0.000, and P=0.022). For distant metastasis, FDG-PET/CT had a sensitivity of 79%, a specificity of 94%, and an accuracy of 93%, compared with 79%, 87%, and 86%, respectively, for CT (P=1.000, P=0.004, and P=0.037). In addition, positive findings of lymph node metastasis and distant metastasis on FDG-PET/CT were associated significantly with cancer recurrence or cancer-related death (P=0.009, P=0.001, respectively).
CONCLUSIONS
Preoperative FDG-PET/CT had a higher specificity and accuracy compared to CT for detection of lymph node metastasis and distant metastasis of CRC. In addition, FDG-PET/CT could be a valuable prognostic tool for CRC.

Keyword

Positron-emission tomography; Computed tomography; Colorectal neoplasms; Diagnosis; Prognosis

MeSH Terms

Colorectal Neoplasms*
Diagnosis
Electrons*
Humans
Lymph Nodes
Neoplasm Metastasis
Positron-Emission Tomography
Prognosis
Recurrence
Sensitivity and Specificity

Figure

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  Fig. 1 Study population. PDG, fluorodeoxyglucose.

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  Fig. 2 Prognosis according to finding for lymph node and distant metastasis on CT scan. (A) Prognosis according to positive finding of lymph node metastasis. (B) Prognosis according to positive finding of distant metastasis.

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  Fig. 3 Prognosis according to finding for lymph node and distant metastasis on fluorodeoxyglucose (FDG)-PET/CT. (A) Prognosis according to positive finding of lymph node metastasis on FDG-PET/CT. (B) Prognosis according to positive finding of distant metastasis on FDG-PET/CT.

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