J of IMAB 2012; 18(1):250-256
INFLUENCE OF THE FDG-PET/CT ON THE DIAGNOSE AND STAGING OF COLORECTAL CANCER.
Nikola Y. Kolev, Anton Y. Tonev, Valentin L. Ignatov, Georgi H. Ivanov, Aleksander K. Zlatarov, Georgi Todorov, Krasimir D. Ivanov
1st Clinic of Surgery, University Hospital “St. Marina”, Varna, Medical University of Varna, Bulgaria.

ABSTRACT:
INTRODUCTION: In patients with colorectal cancer (CRC), preoperative evaluation and staging should focus on techniques that might alter the preoperative or intraoperative surgical plan. Conventional imaging methods (CT, MRI) have low accuracy for identifying the depth of tumour infiltration and have limited ability to detect regional lymph node involvement. The aim of this study was to evaluate the utility of FDG-PET in the initial staging of patients with CC in comparison with conventional staging methods and to determine its impact on therapeutic management.
METHODS: In First Clinic of Surgery at University Hospital “St. Marina” one hundred and four patients with a diagnosis of CRC (53 males and 51 females; mean age 66.76± 12.36 years), selected prospectively. All patients were studied for staging using a standard procedure (CT) and FDG-PET. The reference method was histology. The effect of FDG-PET on the diagnose and the operative treatment was studied.
RESULTS: In 14 patients, surgery was contraindicated by FDG-PET owing to the extent of disease (only 6/14 suspected by CT). FDG-PET revealed four synchronous tumours. For N staging, both procedures showed a relatively high specificity but a low diagnostic accuracy (PET 56%, CT 60%) and sensitivity (PET 21%, CT 25%). For M assessment, diagnostic accuracy was 92% for FDGPET and 87% for CT. FDG-PET results led to modification of the therapy approach in 17.85% of the patients with rectal cancer and in 14.8% of the patients with colon cancer.
CONCLUSION: Compared with conventional techniques, FDGPET appears to be useful in pre-surgical staging of CC, revealing unsuspected disease and impacting on the treatment approach.

Key words: 18F-FDG, Position emission tomography, Colorectal cancer, Staging.

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Please cite this article as: Kolev NY, Tonev AY, Ignatov VL, Ivanov GH, Zlatarov AK, Todorov G, Ivanov KD. INFLUENCE OF THE FDG-PET/CT ON THE DIAGNOSE AND STAGING OF COLORECTAL CANCER. J of IMAB. 2012; 18(1):250-256; doi: 10.5272/jimab.2012181.250

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Accepted for publication: 18 November 2011
Issue published online: 29 June 2012

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