Diagnostic Accuracy of Colorectal Cancer Staging With Whole-Body PET/CT Colonography

Veit-Haibach, Patrick; Kuehle, Christiane A.; Beyer, Thomas; Stergar, H.; Kuehl, Hilmar; Schmidt, J.; Börsch, G; G, Dahmen; Barkhausen, Joerg; Bockisch, Andreas; Antoch, Gerald

doi:10.1001/jama.296.21.2590

Cited by 109 publications

(60 citation statements)

References 32 publications

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“…The reason for this is predominantly related to specificity issues with the structural abnormalities found by this modality. Because combined 18 F-FDG PET/CT has already shown its superiority over PET or CT alone in staging and restaging of patients with colorectal cancer, patients with inconclusive ceCT findings now are being frequently referred for further evaluation with 18 F-FDG PET/CT (11,17).…”

Section: Discussionmentioning

confidence: 99%

“…A size-related cutoff of 1.0-cm short-axis diameter has been used to define malignant lymph nodes on ceCT only. Recent publications have shown that in different areas malignant lymph node sizes can vary between medical conditions and tumor entities (17,22). However, a general 1.0-cm threshold for lymph node assessment is still widely accepted, and further research must be done with regard to lymph node sizes in different body compartments under different medical conditions.…”

Section: Figurementioning

confidence: 99%

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Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced ¹⁸F-FDG PET/CT the Diagnostic Tool of Choice?

Soyka¹,

Veit-Haibach²,

Strobel³

et al. 2008

J Nucl Med

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18 F-FDG PET/CT has gained wide acceptance for evaluation of recurrent colorectal carcinoma. However in clinical practice, contrast-enhanced CT (ceCT) is still the first-line restaging tool. The aim of this study was to investigate the value of contrastenhanced PET/CT (cePET/CT) as a first-line restaging tool with a special focus on the importance of the use of intravenous contrast. Methods: Fifty-four patients (17 women, 37 men; mean age, 60.3 y), referred for restaging of colorectal carcinoma, were examined with cePET/CT. Retrospective analysis was performed by 2 experienced readers by consensus: first, ceCT alone; second, non-cePET/CT; and third, cePET/CT. The number, localization, and diagnostic certainty of lesions were evaluated. Additionally, the therapeutic impact of the findings was determined. In 29 patients, histology, clinical imaging, and clinical follow-up served as the reference standard. In 25 patients, clinical follow-up and imaging served as the reference standard. Results: Overall, non-cePET/CT delivered correct additional information to the ceCT findings in 27 of 54 patients (50%). This occurred in (a) 20 of 30 patients, where ceCT was found to be inconclusive, and in (b) 7 of 24 patients with conclusive ceCT findings, where non-cePET/CT found additional lesions, leading to a therapy modification in 5 patients. Compared with non-cePET/ CT, cePET/CT revealed additional information in 39 of 54 patients (72%), with therapeutic relevance in 23 patients. This large number was primarily due to correct segmental localization of liver metastases, which is crucial for surgical therapy planning. Conclusion: On the basis of its higher accuracy and therapeutic impact compared with ceCT, our data suggest that cePET/CT might be considered as the first-line diagnostic tool for restaging in patients with colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced ¹⁸F-FDG PET/CT the Diagnostic Tool of Choice?

Soyka¹,

Veit-Haibach²,

Strobel³

et al. 2008

J Nucl Med

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“…In PET/CT scans involving 18 F-FDG a possibility of accurate assessment of the T stage was documented in many diagnoses, e.g. in head and neck tumors, non-small-cell carcinoma of the lungs and large intestine cancer [26][27][28][29]. The evaluation of local tumor invasion is based primarily on morphological data, that is why the MR component in PET/MR scans may turn out to be better than CT in PET/CT scans, especially in those tumors, in which high soft tissue contrast in MR images would enable higher image accuracy, as for example, in breast, prostate, head and neck, liver cancer, muscle and bone system or brain tumors.…”

Section: Application Of Pet/mr Scans In Oncologymentioning

confidence: 99%

PET/MR — a rapidly growing technique of imaging in oncology and neurology

Sałyga

Guzikowska-Ruszkowska²,

Czepczyński

et al. 2016

Nucl. Med. Rev.

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“…T staging FDG PET/CT has been shown to be capable of accurately determining T stage in a few indications, such as head and neck tumors, non-small lung cancer and colorectal cancer [25][26][27][28]. However, since the evaluation of local tumor extent relies mainly on morphological data because of high spatial resolution, and the functional component of hybrid imaging does not add information on T stage, PET/MRI could prove to be superior to PET/CT in those indications in which MRI has been found to be more accurate than CT.…”

Section: Whole-body Fdg Pet/mrimentioning

confidence: 99%

Whole-body PET/MRI in oncology: current status and clinical applications

Pace

Nicolai

Aiello

et al. 2013

Clin Transl Imaging

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In oncology, diagnostic imaging plays a major role in staging, therapy assessment and in the evaluation of tumor biology. Multimodality imaging, and more specifically positron emission tomography/computed tomography (PET/CT), has matured into an important imaging tool. The recent introduction of the integrated whole-body PET/ magnetic resonance imaging (MRI) represents the addition of a promising methodology in clinical practice. Combining the metabolic data of PET with the anatomical and functional information provided by MRI and fMRI may further improve the diagnostic value of each method alone. Although the literature is still limited, data indicate a potential advantage of PET/MRI over PET/CT in all the indications where MRI is superior to CT, as well as in the evaluation of tumor biology. Integrated PET/MRI might be performed in addition to the existing imaging modality in specific regions. Moreover, integrated PET/MRI is an alternative to PET/CT when a low radiation dose is required, i.e. in children and in repeated imaging. In the rapidly evolving field of diagnostic imaging, the role of a new modality should be accurately evaluated. Further studies are needed to test the diagnostic accuracy of PET/MRI in different oncology indications. Whether PET/MRI will replace PET/CT or be a complementary methodology and whether it represents true diagnostic progress remains to be evaluated, also taking into account economic considerations.

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Diagnostic Accuracy of Colorectal Cancer Staging With Whole-Body PET/CT Colonography

Abstract: In this preliminary study, PET/CT colonography is at least equivalent to CT + PET for tumor staging in patients with colorectal cancer. Thus, PET/CT colonography in conjunction with optical colonoscopy may be a suitable concept of tumor staging for patients with colorectal cancer.

Cited by 109 publications

References 32 publications

Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced ¹⁸F-FDG PET/CT the Diagnostic Tool of Choice?

Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced ¹⁸F-FDG PET/CT the Diagnostic Tool of Choice?

PET/MR — a rapidly growing technique of imaging in oncology and neurology

Whole-body PET/MRI in oncology: current status and clinical applications

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Diagnostic Accuracy of Colorectal Cancer Staging With Whole-Body PET/CT Colonography

Abstract: In this preliminary study, PET/CT colonography is at least equivalent to CT + PET for tumor staging in patients with colorectal cancer. Thus, PET/CT colonography in conjunction with optical colonoscopy may be a suitable concept of tumor staging for patients with colorectal cancer.

Cited by 109 publications

References 32 publications

Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced 18F-FDG PET/CT the Diagnostic Tool of Choice?

Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced 18F-FDG PET/CT the Diagnostic Tool of Choice?

PET/MR — a rapidly growing technique of imaging in oncology and neurology

Whole-body PET/MRI in oncology: current status and clinical applications

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Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced ¹⁸F-FDG PET/CT the Diagnostic Tool of Choice?

Staging Pathways in Recurrent Colorectal Carcinoma: Is Contrast-Enhanced ¹⁸F-FDG PET/CT the Diagnostic Tool of Choice?