Utility of 18-fluorodeoxyglucose positron emission/computed tomography in the management of recurrent colorectal cancer

作者：Liong Sue Y; Kochhar Rohit; Renehan Andrew G; Manoharan Prakash^*

来源：ANZ Journal of Surgery, 2012, 82(10): 729-736.

DOI：10.1111/j.1445-2197.2012.06237.x

• colorectal cancer
• computed tomography
• metastasis
• positron emission tomography
• recurrence

Background This study aimed to evaluate the utility of 18-fluorodeoxyglucose positron emission/computed tomography (PET/CT) in the management of colorectal cancer (CRC) patients with suspected recurrence. Methods Clinical and imaging histories of CRC patients who underwent PET/CT at our institution between 1 April 2007 and 31 August 2008 for evaluation of recurrent disease were retrospectively reviewed. Patients were divided into two groups (A) patients evaluated for suspected local recurrence (based on conventional imaging) and (B) patients with carcinoembryonic antigen (CEA) levels in excess of 5?ng/mL; in whom conventional imaging was either normal or equivocal. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were derived using either histopathology or follow-up imaging as the standard of reference. Results In group A (n = 44), the sensitivity, specificity, PPV, NPV and accuracy of PET/CT were 100% (95% confidence interval (CI): 86.7100), 84.2% (95% CI: 62.494.5), 89.3% (95% CI: 72.896.3), 100% (95% CI: 80.6100) and 93.2%, respectively. In group B (n = 18), the sensitivity, specificity, PPV and NPV of PET/CT were 76.9% (95% CI: 49.791.8), 60.0%, (95% CI: 23.188.2), 83.3% (95% CI: 55.295.3) and 50% (95% CI: 18.881.2), respectively. Conclusion PET/CT has high accuracy in the assessment of local recurrence, particularly with regard to its NPV. PET/CT is useful for problem solving in cases of unexplained elevated CEA levels.

• 出版日期2012-10