| Staging pathways in recurrent colorectal carcinoma: is contrast-enhanced 18F-FDG PET/CT the diagnostic tool of choice? | |
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MedLine Citation:
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PMID: 18287263 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 contrast-enhanced 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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Authors:
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Jan D Soyka; Patrick Veit-Haibach; Klaus Strobel; Stefan Breitenstein; Alois Tschopp; Katja A Mende; Marisol Perez Lago; Thomas F Hany |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article Date: 2008-02-20 |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 49 ISSN: 0161-5505 ISO Abbreviation: J. Nucl. Med. Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-06 Completed Date: 2008-05-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 354-61 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, University Hospital Zuerich, Zurich, Switzerland. jan.soyka@usz.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Colorectal Neoplasms
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diagnosis* Contrast Media Female Fluorodeoxyglucose F18 / diagnostic use* Humans Image Enhancement / methods* Male Middle Aged Neoplasm Recurrence, Local / diagnosis* Neoplasm Staging Positron-Emission Tomography / methods* Radiopharmaceuticals / diagnostic use Reproducibility of Results Sensitivity and Specificity Tomography, X-Ray Computed / methods* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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