Additional value of whole-body positron emission tomography with fluorine-18-2-fluoro-2-deoxy-d-glucose in recurrent colorectal cancer

Flamen, Patrick; Stroobants, Sigrid; Van Cutsem, Eric; Dupont, Patrick; Bormans, Guy; De Vadder, Nancy; Penninckx, Freddy; Van Hoe, Lieven; Mortelmans, Luc

doi:10.1200/JCO.1999.17.3.894

Title

Additional value of whole-body positron emission tomography with fluorine-18-2-fluoro-2-deoxy-d-glucose in recurrent colorectal cancer

Author

Flamen, Patrick

Stroobants, Sigrid

Van Cutsem, Eric

Dupont, Patrick

Bormans, Guy

De Vadder, Nancy

Penninckx, Freddy

Van Hoe, Lieven

Mortelmans, Luc

Abstract

PURPOSE: To assess the additional value of the whole-body [18F]-2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) scan as a staging modality complementing conventional diagnostic methods (CDM) in patients suspected of having recurrent colorectal adenocarcinoma. PATIENTS AND METHODS: In 103 patients, the discordances between FDG-PET and CDM results were identified and related to the final diagnosis obtained by histopathology or clinical follow-up (> 1 year). All FDG-PET studies were reviewed with full knowledge of the CDM findings. RESULTS: In a region-based analysis, discordances between CDM and FDG-PET findings were found in 40 of 412 regions (10%). In these, FDG-PET had additional diagnostic value in 14 of 16 locoregional, six of seven hepatic, seven of eight abdominal, and eight of nine extra-abdominal regions. In a patient-based analysis, CDM categorized a subgroup of 60 patients as having resectable recurrent disease limited to the liver (n = 37) or locoregional region (n = 23). In 13 of these patients, there were discordant FDG-PET findings, detecting additional tumor sites in nine patients and excluding disease in three patients and yielding an additional diagnostic value in 20% of the patients. A second subgroup consisted of 13 patients with inconclusive CDM findings (n = 5) or with elevated plasma carcinoembryonic antigen levels and an otherwise negative conventional work-up (n = 8). In these patients, FDG-PET results were correct in eight of nine discordances, yielding a positive additional diagnostic value in 62% of the patients. CONCLUSION: Whole-body FDG-PET can have a clear impact on the therapeutic management in the follow-up of patients with colorectal cancer.

Language

English

Source (journal)

Journal of clinical oncology. - New York

Publication

New York : 1999

ISSN

0732-183X

DOI

10.1200/JCO.1999.17.3.894

Volume/pages

17 :3 (1999) , p. 894-901