ABSTRACT
PURPOSE: To evaluate whether PET/CT could be used to assess the extent of colorectal peritoneal metastases. METHODS: All patients who underwent a PET/CT scan before a CRS-HIPEC procedure between January 1, 2010 and December 31, 2013 were retrospectively included (n = 35). Two nuclear medicine physicians (observer 1 and observer 2) separately reviewed the scans on intraperitoneal abnormalities. A simplified PCI was used to compare the extent of rPCI versus sPCI. RESULTS: Included patients had a median age of 60.6 years. Histology of primary tumors were 51.5% adenocarcinomas, 37.1% mucinous adenocarcinoma, and 11.4% SRCC. Median sPCI was 9.5 (5.0-11.8) and median rPCI was 5.0 (3.0-7.0) for observer 1 and 4.0 (3.0-6.0) for observer 2 (p = 0.02 and p = 0.01, respectively). When compared to the surgical data, PET/CT showed a poor correlation for assessing the extent of PC for both adenocarcinoma (observer 1 rho - 0.17, p = 0.51 and observer 2 rho 0.13, p = 0.61) as well as mucinous carcinoma or SRCC (observer 1 rho 0.44, p = 0.08 and observer 2 rho 0.38, p = 0.14). CONCLUSION: PET/CT underestimates the extent of PC during surgery in both mucinous and non-mucinous CRC and is not recommended for intraperitoneal tumor scoring.
Subject(s)
Colorectal Neoplasms/pathology , Peritoneal Neoplasms/diagnostic imaging , Peritoneal Neoplasms/secondary , Positron Emission Tomography Computed Tomography/methods , Female , Fluorodeoxyglucose F18 , Humans , Male , Middle Aged , Preoperative Period , Radiation Dosage , Radiopharmaceuticals , Retrospective StudiesABSTRACT
Colorectal cancer is one of the most common malignancies in the Western world. Most colorectal cancers show fluorodeoxyglucose (FDG) uptake, although in mucinous adenocarcinoma uptake may be limited. A literature search was conducted regarding the impact of FDG-PET/computed tomography (CT) on management and outcome in patients with colorectal carcinoma. FDG-PET/CT can have a significant clinical impact on patient management in various stages of the disease. In patients with suspected recurrent disease and patients with liver metastases who might be eligible for surgery FDG-PET/CT can have more benefit than conventional imaging. FDG-PET/CT can be a useful modality to monitor treatment response.
