Whole-body FDG-PET in patients with recurrent colorectal carcinoma. A comparative study with CT

Massimo Imbriaco; Tim Akhurst; Susan Hilton; Henry W.D. Yeung; Homer A. Macapinlac; Madhu Mazumdar; Leonardo Pace; Nancy Kemeny; Yusuf Erdi; Alfred Cohen; Yuman Fong; Jose Guillem; Steven M. Larson

doi:10.1016/S1095-0397(00)00045-5

Whole-body FDG-PET in patients with recurrent colorectal carcinoma. A comparative study with CT

Massimo Imbriaco, Tim Akhurst, Susan Hilton, Henry W.D. Yeung, Homer A. Macapinlac, Madhu Mazumdar, Leonardo Pace, Nancy Kemeny, Yusuf Erdi, Alfred Cohen, Yuman Fong, Jose Guillem, Steven M. Larson

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33 Scopus citations

Abstract

Purpose: To assess the clinical accuracy of whole-body 2-[F-18]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) in the diagnosis of recurrent colorectal carcinoma in comparison to conventional computed tomography (CT). Materials and methods: Forty patients with suspected recurrent colorectal carcinoma based on either progressive serial carcinoemrbyonic antigen (CEA) serum elevation or positive/equivocal CT findings underwent whole-body FDG-PET. PET results were compared with those of CT and correlated to the final histopathological and clinical findings. Results: A final diagnosis was obtained at 93 sites in 35 patients by histology and in 5 patients by clinical follow up of at least 6 months. Of the 93 sites, 53 were determined to be malignant and 40 benign. FDG-PET evaluated on a 5-point scale (0-4) showed a positive and negative predictive value in the range of 96-98% and 83-93% respectively as the threshold for positivity was moved from 0 through 3. By comparison, CT, also evaluated on a 5-point scale showed a positive and negative predictive value in the range of 75-88%> and 67-71%> respectively. The area under the fitted receiver operating characteristic curve for PET: A_PET = 0.96 ± 0.02 was significantly greater (P < 0.001) than that observed for CT: A_CT = 0.77 ± 0.06. The distribution of maximum standardized uptake value (SUVmax) showed that all negative lesions have SUVmax below 5.0 whereas 75% of positive lesions were above 5.0 pointing to the fact that disease positivity is more likely in lesions with high SUV values. Conclusion: The results of this study confirm that whole-body FDG-PET is more accurate than conventional CT in the staging of patients with suspected recurrent colorectal carcinoma.

Original language	English (US)
Pages (from-to)	107-114
Number of pages	8
Journal	Clinical Positron Imaging (Netherlands)
Volume	3
Issue number	3
DOIs	https://doi.org/10.1016/S1095-0397(00)00045-5
State	Published - Jun 1 2000
Externally published	Yes

Keywords

CT
Colon neoplasms
FDG
PET

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.1016/S1095-0397(00)00045-5

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Imbriaco, M., Akhurst, T., Hilton, S., Yeung, H. W. D., Macapinlac, H. A., Mazumdar, M., Pace, L., Kemeny, N., Erdi, Y., Cohen, A., Fong, Y., Guillem, J., & Larson, S. M. (2000). Whole-body FDG-PET in patients with recurrent colorectal carcinoma. A comparative study with CT. Clinical Positron Imaging (Netherlands), 3(3), 107-114. https://doi.org/10.1016/S1095-0397(00)00045-5

@article{99c2cc618cdf40f6a0f72f43b9aff302,

title = "Whole-body FDG-PET in patients with recurrent colorectal carcinoma. A comparative study with CT",

abstract = "Purpose: To assess the clinical accuracy of whole-body 2-[F-18]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) in the diagnosis of recurrent colorectal carcinoma in comparison to conventional computed tomography (CT). Materials and methods: Forty patients with suspected recurrent colorectal carcinoma based on either progressive serial carcinoemrbyonic antigen (CEA) serum elevation or positive/equivocal CT findings underwent whole-body FDG-PET. PET results were compared with those of CT and correlated to the final histopathological and clinical findings. Results: A final diagnosis was obtained at 93 sites in 35 patients by histology and in 5 patients by clinical follow up of at least 6 months. Of the 93 sites, 53 were determined to be malignant and 40 benign. FDG-PET evaluated on a 5-point scale (0-4) showed a positive and negative predictive value in the range of 96-98% and 83-93% respectively as the threshold for positivity was moved from 0 through 3. By comparison, CT, also evaluated on a 5-point scale showed a positive and negative predictive value in the range of 75-88%> and 67-71%> respectively. The area under the fitted receiver operating characteristic curve for PET: APET = 0.96 ± 0.02 was significantly greater (P < 0.001) than that observed for CT: ACT = 0.77 ± 0.06. The distribution of maximum standardized uptake value (SUVmax) showed that all negative lesions have SUVmax below 5.0 whereas 75% of positive lesions were above 5.0 pointing to the fact that disease positivity is more likely in lesions with high SUV values. Conclusion: The results of this study confirm that whole-body FDG-PET is more accurate than conventional CT in the staging of patients with suspected recurrent colorectal carcinoma.",

keywords = "CT, Colon neoplasms, FDG, PET",

author = "Massimo Imbriaco and Tim Akhurst and Susan Hilton and Yeung, {Henry W.D.} and Macapinlac, {Homer A.} and Madhu Mazumdar and Leonardo Pace and Nancy Kemeny and Yusuf Erdi and Alfred Cohen and Yuman Fong and Jose Guillem and Larson, {Steven M.}",

note = "Funding Information: This work was supported in part by The Laurent and Alberta Gerschel Foundation. We would also like to thank Dr. Ronald Castellino for his valuable suggestions in the preparation of the manuscript.",

year = "2000",

month = jun,

day = "1",

doi = "10.1016/S1095-0397(00)00045-5",

language = "English (US)",

volume = "3",

pages = "107--114",

journal = "Clinical Positron Imaging (Netherlands)",

issn = "1095-0397",

publisher = "Springer New York",

number = "3",

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TY - JOUR

T1 - Whole-body FDG-PET in patients with recurrent colorectal carcinoma. A comparative study with CT

AU - Imbriaco, Massimo

AU - Akhurst, Tim

AU - Hilton, Susan

AU - Yeung, Henry W.D.

AU - Macapinlac, Homer A.

AU - Mazumdar, Madhu

AU - Pace, Leonardo

AU - Kemeny, Nancy

AU - Erdi, Yusuf

AU - Cohen, Alfred

AU - Fong, Yuman

AU - Guillem, Jose

AU - Larson, Steven M.

N1 - Funding Information: This work was supported in part by The Laurent and Alberta Gerschel Foundation. We would also like to thank Dr. Ronald Castellino for his valuable suggestions in the preparation of the manuscript.

PY - 2000/6/1

Y1 - 2000/6/1

N2 - Purpose: To assess the clinical accuracy of whole-body 2-[F-18]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) in the diagnosis of recurrent colorectal carcinoma in comparison to conventional computed tomography (CT). Materials and methods: Forty patients with suspected recurrent colorectal carcinoma based on either progressive serial carcinoemrbyonic antigen (CEA) serum elevation or positive/equivocal CT findings underwent whole-body FDG-PET. PET results were compared with those of CT and correlated to the final histopathological and clinical findings. Results: A final diagnosis was obtained at 93 sites in 35 patients by histology and in 5 patients by clinical follow up of at least 6 months. Of the 93 sites, 53 were determined to be malignant and 40 benign. FDG-PET evaluated on a 5-point scale (0-4) showed a positive and negative predictive value in the range of 96-98% and 83-93% respectively as the threshold for positivity was moved from 0 through 3. By comparison, CT, also evaluated on a 5-point scale showed a positive and negative predictive value in the range of 75-88%> and 67-71%> respectively. The area under the fitted receiver operating characteristic curve for PET: APET = 0.96 ± 0.02 was significantly greater (P < 0.001) than that observed for CT: ACT = 0.77 ± 0.06. The distribution of maximum standardized uptake value (SUVmax) showed that all negative lesions have SUVmax below 5.0 whereas 75% of positive lesions were above 5.0 pointing to the fact that disease positivity is more likely in lesions with high SUV values. Conclusion: The results of this study confirm that whole-body FDG-PET is more accurate than conventional CT in the staging of patients with suspected recurrent colorectal carcinoma.

AB - Purpose: To assess the clinical accuracy of whole-body 2-[F-18]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) in the diagnosis of recurrent colorectal carcinoma in comparison to conventional computed tomography (CT). Materials and methods: Forty patients with suspected recurrent colorectal carcinoma based on either progressive serial carcinoemrbyonic antigen (CEA) serum elevation or positive/equivocal CT findings underwent whole-body FDG-PET. PET results were compared with those of CT and correlated to the final histopathological and clinical findings. Results: A final diagnosis was obtained at 93 sites in 35 patients by histology and in 5 patients by clinical follow up of at least 6 months. Of the 93 sites, 53 were determined to be malignant and 40 benign. FDG-PET evaluated on a 5-point scale (0-4) showed a positive and negative predictive value in the range of 96-98% and 83-93% respectively as the threshold for positivity was moved from 0 through 3. By comparison, CT, also evaluated on a 5-point scale showed a positive and negative predictive value in the range of 75-88%> and 67-71%> respectively. The area under the fitted receiver operating characteristic curve for PET: APET = 0.96 ± 0.02 was significantly greater (P < 0.001) than that observed for CT: ACT = 0.77 ± 0.06. The distribution of maximum standardized uptake value (SUVmax) showed that all negative lesions have SUVmax below 5.0 whereas 75% of positive lesions were above 5.0 pointing to the fact that disease positivity is more likely in lesions with high SUV values. Conclusion: The results of this study confirm that whole-body FDG-PET is more accurate than conventional CT in the staging of patients with suspected recurrent colorectal carcinoma.

KW - CT

KW - Colon neoplasms

KW - FDG

KW - PET

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Whole-body FDG-PET in patients with recurrent colorectal carcinoma. A comparative study with CT

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