Detection of Resectable Recurrences in Colorectal Cancer Patients with 2-[18F]Fluoro-2-Deoxy-D-Glucose-Positron Emission Tomography/Computed Tomography

• Published in: Cancer biotherapy & radiopharmaceuticals Vol. 28; no. 6; pp. 479 - 487
• Main Authors: PENG, Nan-Jing, CHIN HU, KING, Tai-Ming, CHIU, Yu-Li, WANG, Jui-Ho, LIU, Ren-Shyan
• Format: Journal Article
• Language: English
• Published: New Rochelle, NY Liebert 01.07.2013; Mary Ann Liebert, Inc
• Subjects: Adult; Aged; Antineoplastic agents; Biological and medical sciences; Colorectal Neoplasms - diagnostic imaging; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Female; Fluorodeoxyglucose F18; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Medical sciences; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Original; Pharmacology. Drug treatments; Positron-Emission Tomography - methods; Radiopharmaceuticals; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tomography, X-Ray Computed - methods; Treatment Outcome; Tumors; Human; Relapse; Rectal disease; Colorectal cancer; Fludeoxyglucose (18F); Malignant tumor; Colonic disease; Digestive diseases; Intestinal disease; Computerized axial tomography; Diagnosis; Detection; Positron emission tomography; Cancer; Emission tomography
• ISSN: 1084-9785; 1557-8852
• DOI: 10.1089/cbr.2012.1382

To evaluate the usefulness of 2-[(18)F]fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in the early detection of resectable recurrences of colorectal cancer (CRC) and the impacts on the clinical disease management. FDG-PET/CT was performed on patients with elevated serum carcinoembryonic antigen (CEA) levels >5 ng/mL (Group 1) or suspicious recurrences without rise in serum CEA levels (Group 2). The results were analyzed on the basis of histological data, disease progression, and/or clinical follow-up. Recurrence was defined as evidence of recurrent lesions within 6 months of the FDG-PET/CT scan. Resectable recurrences and changes in management were calculated based on medical records. In our study, 128 consecutive FDG-PET/CT analyses (n=49 in Group 1 and n=79 in Group 2) were performed on 96 recruited patients. Recurrences were proven in 63. The overall sensitivity, specificity, and accuracy of FDG-PET/CT were 98.4%, 89.2%, and 93.8%, respectively, and were 100%, 88.9%, and 95.9% in Group 1 and 96.9% and 89.4% and 92.4% in Group 2, respectively. Surgical resections were performed in 38.7% (12/31) of Group 1 patients and 53.1% (17/32) of Group 2 patients. FDG-PET/CT induced changes in planned management in 48.4% (62/128) of all patients, which included 63.3% (31/49) of Group 1 patients and 39.2% (31/79) of Group 2 patients (p=0.008). After a follow-up, 3.4% (1/29) of patients who underwent surgical resection of recurrent lesions and 34.3% (11/34) patients who did not undergo resection died at the end of study (p=0.004). The surgical resection of limited recurrent disease, as determined by FDG-PET/CT, improves the survival of CRC patients. FDG-PET/CT should be performed not only in patients with elevated serum CEA levels, but also in those in whom recurrences are suspected to improve the early detection of resectable disease.