The Impact of FDG-PET for the Preoperative Management of Patients with Colorectal Cancer

Abstract

Objective: Whole-body fluorodeoxyglucose-positron emission tomography (FDG-PET) has proved effective in the diagnosis of recurrent colorectal cancer (CRC) and in the monitoring of cancer therapy. However there have been limited studies considering the effect of FDG-PET in the initial evaluation of CRC. We analysed how FDG-PET affects the management of patients with CRC preoperatively.Material and Methods: A prospective study of 26 consecutive patients with known or suspected CRC was undertaken. The patients were evaluated by computed tomography (CT) and FDG-PET. FDG-PET results were compared with those of CT and correlated with histopathologic findings or with clinical course. Results: FDG-PET had a sensitivity of 96% and positive predictive value of 100% for the diagnosis of primary cancer, while CT had values of 68% and 95%, respectively. FDG-PET was superior to CT in detecting additional metastatic disease with a sensitivity of 89%, while CT had 33%. FDG-PET resulted in altered management for 8 patients of whom three avoided inappropriate surgery.Conclusion: It is concluded that FDG-PET is highly sensitive for the diagnosis and staging of patients with CRC. Its use in conjunction with CT results in a more accurate selection of patients for surgical treatment with curative intent.

Keywords

• Colorectal cancer
• FDG-PET
• patient management