Selective Use of 18F-Fluorodeoxyglucose-Positron Emission Tomography and Computed Tomography in the Management of Metastatic Disease from Colorectal Cancer Results from a regional centre
Journal Title: Sultan Qaboos University Medical Journal - Year 2015, Vol 15, Issue 1
Abstract
Objectives: Computed tomography (CT) scans are routinely used for primary staging and disease surveillance in patients with colorectal cancer. However, these scans have limited sensitivity in some organs and can only detect lesions with morphological changes, whereas 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) scans are able to detect areas of metabolic change before morphological changes appear. Te aim of this study was to evaluate the impact of 18F-FDG-PET/CT scans over conventional imaging during preoperative work-ups or follow-ups in a selected group of patients. Methods: Tis retrospective cohort study, which took place between July 2009 and May 2011, assessed 1,043 patient records from the South East Scotland Cancer Network colorectal cancer database. A total of 102 patients who underwent 18F-FDG-PET/CT scans in addition to conventional imaging were included in the study. Tese patients had potentially resectable metastases, equivocal fndings on CT scans and elevated carcinoembryonic antigen levels with negative conventional imaging. Results: Of the 102 patients included in the study, 22 underwent a preoperative 18F-FDG-PET/CT scan and 80 underwent a follow-up 18F-FDG-PET/CT scan. In the preoperative scan group, the 18F-FDG-PET/CT scan had a major impact on 16 patients (72.75%) and no impact on six patients (27.25%). In the follow-up scan group, the 18F-FDG-PET/CT scan had a major impact on 51 (63.75%), a minor impact on four (5%), no impact on 22 (27.5%) and a negative impact on three (3.75%) patients. Conclusion: Te results of this study demonstrated that 18F-FDGPET/CT scans have a considerable effect on disease management when undertaken among indicated colorectal cancer patients.
Authors and Affiliations
Sadaf Jafferbhoy| Colorectal Unit, Western General Hospital, Edinburgh, UK, Adam Chambers| Colorectal Unit, Western General Hospital, Edinburgh, UK, James Mander| Colorectal Unit, Western General Hospital, Edinburgh, UK, Hugh Paterson| Colorectal Unit, Western General Hospital, Edinburgh, UK
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