Clinical significance of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in the follow-up of colorectal cancer: searching off approaches increasing specificity for detection of recurrence Cover

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Clinical significance of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in the follow-up of colorectal cancer: searching off approaches increasing specificity for detection of recurrence

Radiology and Oncology

Volume 51 (2017): Issue 4 (December 2017)

By: Semra Ince, Kursat Okuyucu, Oguz Hancerliogulları, Engin Alagoz, Huseyin San and Nuri Arslan

Open Access

|Nov 2017

Figures & Tables

Box-plot graph illustrating the distribution of SUVmax through benign conditions and disease recurrence.

ROC curve drawn to indicate the detection and diagnostic accuracy of SUVmax in recurrence/metastasis.

A female patient aged 51 years with rectum cancer was operated and treated by chemoradiotherapy. MRI findings revealed suspected metastasis with serum CEA and Ca 19-9 in normal range during the follow-up. Her axial PET (A), CT (B), fusion (C) and coronal PET (D), CT (E), fusion (F) images on 18F-FDG-PET/CT showed a focal uptake in sigmoid colon with a SUVmax of 13.7 and TLG of 272 accompanied by wall thickening causing a mass lesion on CT component (arrows). Histopathology established the diagnosis as recurrence.

A female patient aged 73 years with sigmoid colon cancer was operated and treated by chemoradiotherapy. Her serum CEA level was 3.2 ng/ml, and Ca 19-9 was 7.3 U/ml. In the evaluation of treatment response; axial PET (A), CT (B), fusion (C) and coronal PET (D), fusion (E) images on 18F-FDG-PET/CT exhibited a diffuse uptake in sigmoid colon with a SUVmax of 10.1 and TLG of 154 accompanied by wall thickening on CT component (arrows). This uptake raised the suspicion of a probable recurrence, but histopathology confirmed it as benign.

18F-FDG-PET/CT results, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) according to final histopathologic diagnosis

Histopathologic diagnosis	¹⁸F-FDG-PET/CT Results

	Positive	Negative	Sensitivity	Specificity	PPV	NPV	Total (n)
Malignant	TP = 24	FN = 0					24
Benign	FP = 14	TN = 15					29
Total (n)	38	15	100%	51.7%	63.1%	100%	53

Locations of pathologic FDG uptake

Sites of abnormal FDG uptake	n
Anostomosis line (area)	7
Rectum	9
Rectosigmoid region	11
Liver	9
Caecum	1
Kidney	1
Abdominal mass	4
Presacral mass	5
Sigmoid region	3
Descending colon	2
Lung	1

Overlap between 18F-FDG-PET/CT findings and conventional imaging modalities (CT or MRI) in histopathologically proven recurrence

	¹⁸F-FDG-PET/CT results
CT/MRI	True positive	True negative	Total (n)
Malign	n	6	17

FDG-PET/CT findings according to serum Ca 19-9 or CEA levels for histopathologically proven recurrence

	¹⁸F-FDG-PET/CT results
Ca 19-9 or CEA levels	True positive	True negative	Total (n)
Elevated	9	1	10
Normal	13	14	27
Total (n)	22	15	37

DOI: https://doi.org/10.1515/raon-2017-0045 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 378 - 385

Submitted on: Jul 19, 2017

Accepted on: Sep 10, 2017

Published on: Nov 1, 2017

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

metabolic tumor markers,

recurrent colorectal cancer,

18F-fluorodeoxyglucose positron emission tomography,

computed tomography

Related subjects:

Clinical medicine,

Internal medicine,

Haematology, oncology,

© 2017 Semra Ince, Kursat Okuyucu, Oguz Hancerliogulları, Engin Alagoz, Huseyin San, Nuri Arslan, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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