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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-14573

Soyka, J D; Veit-Haibach, P; Strobel, K; Breitenstein, S; Tschopp, A; Mende, K A; Lago, M P; Hany, T F (2008). Staging pathways in recurrent colorectal carcinoma: is contrast-enhanced 18F-FDG PET/CT the diagnostic tool of choice? Journal of Nuclear Medicine, 49(3):354-361.

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(18)F-FDG PET/CT has gained wide acceptance for evaluation of recurrent colorectal carcinoma. However in clinical practice, contrast-enhanced CT (ceCT) is still the first-line restaging tool. The aim of this study was to investigate the value of contrast-enhanced PET/CT (cePET/CT) as a first-line restaging tool with a special focus on the importance of the use of intravenous contrast. METHODS: Fifty-four patients (17 women, 37 men; mean age, 60.3 y), referred for restaging of colorectal carcinoma, were examined with cePET/CT. Retrospective analysis was performed by 2 experienced readers by consensus: first, ceCT alone; second, non-cePET/CT; and third, cePET/CT. The number, localization, and diagnostic certainty of lesions were evaluated. Additionally, the therapeutic impact of the findings was determined. In 29 patients, histology, clinical imaging, and clinical follow-up served as the reference standard. In 25 patients, clinical follow-up and imaging served as the reference standard. RESULTS: Overall, non-cePET/CT delivered correct additional information to the ceCT findings in 27 of 54 patients (50%). This occurred in (a) 20 of 30 patients, where ceCT was found to be inconclusive, and in (b) 7 of 24 patients with conclusive ceCT findings, where non-cePET/CT found additional lesions, leading to a therapy modification in 5 patients. Compared with non-cePET/CT, cePET/CT revealed additional information in 39 of 54 patients (72%), with therapeutic relevance in 23 patients. This large number was primarily due to correct segmental localization of liver metastases, which is crucial for surgical therapy planning. CONCLUSION: On the basis of its higher accuracy and therapeutic impact compared with ceCT, our data suggest that cePET/CT might be considered as the first-line diagnostic tool for restaging in patients with colorectal cancer.


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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Date:March 2008
Deposited On:19 Feb 2009 07:49
Last Modified:05 Apr 2016 13:03
Publisher:Society of Nuclear Medicine
Publisher DOI:10.2967/jnumed.107.048249
PubMed ID:18287263

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