Colorectal cancer and 18FDG-PET/CT: what about adding the T to the N parameter in loco-regional staging?

World J Gastroenterol. 2011 Mar 21;17(11):1427-33. doi: 10.3748/wjg.v17.i11.1427.

Abstract

Aim: To evaluate whether FDG-positron emission tomography (PET)/computed tomography (CT) may be an accurate technique in the assessment of the T stage in patients with colorectal cancer.

Methods: Thirty four consecutive patients (20 men and 14 women; mean age: 63 years) with a histologically proven diagnosis of colorectal adenocarcinoma and scheduled for surgery in our hospital were enrolled in this study. All patients underwent FDG-PET/CT preoperatively. The primary tumor site and extent were evaluated on PET/CT images. Colorectal wall invasion was analysed according to a modified T classification that considers only three stages (≤ T2, T3, T4). Assessment of accuracy was carried out using 95% confidence intervals for T.

Results: Thirty five/37 (94.6%) adenocarcinomas were identified and correctly located on PET/CT images. PET/CT correctly staged the T of 33/35 lesions identified showing an accuracy of 94.3% (95% CI: 87%-100%). All T1, T3 and T4 lesions were correctly staged, while two T2 neoplasms were overstated as T3.

Conclusion: Our data suggest that FDG-PET/CT may be an accurate modality for identifying primary tumor and defining its local extent in patients with colorectal cancer.

Keywords: Cancer; Colorectal; Positron emission tomography/computed tomography; Staging.

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / diagnostic imaging
  • Colorectal Neoplasms / pathology
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Radiopharmaceuticals*
  • Tomography, X-Ray Computed*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18