F-18-FDG PET/contrast enhanced CT in the standard surveillance of high risk colorectal cancer patients

作者：Jimenez Londono German Andres; Garcia Vicente Ana Maria; Sanchez Perez Victoria; Jimenez Aragon Fatima; Leon Martin Alberto; Maria Cano Cano Juana; Ferreras Esther Dominguez; Lopez Ober Van Gomez; Arranz Javier Espinosa; Castrejon Angel Maria Soriano

来源：European Journal of Radiology, 2014, 83(12): 2224-2230.

DOI：10.1016/j.ejrad.2014.08.016

• Colorectal cancer
• FDG PET
• Contrast enhanced CT scan
• Surveillance
• Recurrence

Objective: To assess the accuracy of FDG-PET/contrast enhanced CT (FDG-PET/ceCT) in the detection of unsuspected recurrence of colorectal cancer (CRC) in patients with high risk of relapse. Methods: Thirty-three patients (14 females and 19 males, mean age: 62, range: 41-78), with CRC in complete remission, were prospectively included. All patients underwent
FDG-PET/ceCT (58 studies). FDG-PET/ceCT was requested in the surveillance setting, and performed following a standardized protocol. A portal venous phase CT scan was performed after the injection of iodinated contrast agent. An individual and combined assessment of both techniques (PET and ceCT) was performed. Concordant and discordant findings of PET, ceCT and FDG-PET/ceCT were compared in a patient-based and a lesion-based analysis.
The final diagnosis, recurrence or disease free status (DFS), were established by histopathology or clinical/radiological follow-up of at least 6 months. Results: Seven out of 33 patients had a confirmed recurrence and the rest of patients had a DFS.
In a patient-based analysis the sensitivity and specificity of PET, ceCT and PET/ceCT was of 86% and 88%, 86% and 92%, 86% and 85%, respectively.
Attending to the lesion-based analysis, the sensitivity for PET, ceCT and PET/ceCT was of 56%, 71% and 97%, respectively.
Both techniques showed a good concordance in the establishment of the final patient status. However, on a lesion-based analysis, no concordance was observed between them. Conclusion: PET and ceCT seem to have similar value in the detection of unsuspected recurrence of CRC in a patient-based analysis. However, the combined assessment of PET/ceCT improves the accuracy in the lesion-based analysis.

• 出版日期2014-12