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Background: The role of positron emission tomography with the glucose analogue [18F] fluoro-2-deoxy-D-glucose (FDGPET) in the initial staging of disease in patients with primary colorectal cancer (CRC) has not been adequately assessed. Aims: To evaluate the additional value of FDG-PET as a staging modality, complementary to routine multidetector row computed tomography (MDCT) in patients with CRC. Methods: Forty four patients with CRC underwent preoperative MDCT and FDG-PET. The accuracy of intraoperative macroscopic staging was also investigated compared with histopathological diagnosis. All FDG-PET images were evaluated with respect to detectability of the primary tumour, lymph node involvement, and distant metastases. Both MDCT and FDG-PET diagnoses and treatment plan were compared with surgical and histopathological results. Results: Thirty seven patients underwent surgery. Tumour detection rate was 95%(42/44) for MDCT, 100%(44/44) for FDG-PET, and 100%(37/37) for intraoperative macroscopic diagnosis. Pathological diagnosis of T factor was T1 in five, T2 in four, T3 in 24, and T4 in four cases. Concordance rate with pathological findings of T factor was 57%(21/37) for MDCT and 62%(23/37) for macroscopic diagnosis. Lymph node involvement was pathologically positive in 19 cases. Regarding N factor, overall accuracy was 62%(23/37) for MDCT, 59%(22/37) for FDG-PET, and 70%(26/37) for macroscopic diagnosis. For all 44 patients, FDG-PET findings resulted in treatment changes in only one (2%) patient. Conclusion: FDG-PET is not superior to routine MDCT in the initial staging of primary CRC.
Background: The role of positron emission tomography with the glucose analogue [18F] fluoro-2-deoxy-D-glucose (FDGPET) in the initial staging of disease in patients with primary colorectal cancer (CRC) has not been adequately assessed. Aims: To evaluate the additional value of FDG-PET as a staging modality, complementary to routine multidetector row computed tomography (MDCT) in patients with CRC. Methods: Forty four patients with CRC underwent preoperative MDCT and FDG-PET. The accuracy of intraoperative macroscopic staging was also investigated compared with histopathological diagnosis. All FDG-PET images were evaluated with respect to detectability of the primary tumor, lymph node involvement, and distant metastases. Both MDCT and FDG-PET diagnoses and treatment plans were compared with surgical and histopathological results. Results: Thirty seven patients underwent surgery. Tumor detection rate was 95% (42/44) for MDCT, 100% (44/44) for FDG-PET, and 100% (37/37) for intraoperative ma Croscopic diagnosis. Pathological diagnosis of T factor was T1 in five, T2 in four, T3 in 24, and T4 in four cases. Concordance rate with pathological findings of T factor was 57% (21/37) for MDCT and 62% (23 Regarding N factor, overall accuracy was 62% (23/37) for MDCT, 59% (22/37) for FDG-PET, and 70% ( FDG-PET findings were in treatment changes in only one (2%) patient. Conclusion: FDG-PET is not superior to routine MDCT in the initial staging of primary CRC.