1
|
Radiologic Imaging Modalities for Colorectal Cancer. Dig Dis Sci 2022; 67:2792-2804. [PMID: 34328590 DOI: 10.1007/s10620-021-07166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/07/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Studies reported various diagnostic value of radiologic imaging modalities for diagnosis and management of colorectal cancer (CRC). AIMS To summary the diagnosis and management of CRC using computed tomography colonography (CTC), magnetic resonance colonography (MRC), and positron emission tomography (PET)/computed tomography (CT). METHODS Comprehensive literature searches were conducted in PubMed, EmBase, and the Cochrane library for studies published before April 2021. The diagnostic performance of CTC, MRC, and PET/CT for CRC was summarized. RESULTS A total of 54 studies (17 studies for CTC, 8 studies for MRC, and 29 studies for PET/CT) were selected for final analysis. The sensitivity and specificity for CTC ranged from 27 to 100%, 88 to 100%, respectively, and the pooled sensitivity and specificity for CTC were 0.97 (95% CI 0.88-0.99) and 0.99 (95% CI 0.99-1.00). The sensitivity and specificity for MRC ranged from 48 to 100%, 60 to 100%, respectively, and the pooled sensitivity and specificity for MRC were 0.98 (95% C: 0.77-1.00) and 0.94 (95% CI 0.84-0.98). The sensitivity and specificity for PET/CT ranged from 84 to 100%, 33 to 100%, respectively, and the pooled sensitivity and specificity for PET/CT were 0.94 (95% CI 0.92-0.96) and 0.94 (95% CI 0.90-0.97). The area under the receiver operating characteristic curve for CTC, MRC, and PET/CT was 1.00 (95% CI 0.99-1.00), 0.99 (95% CI 0.98-1.00), and 0.97 (0.95% CI 0.95-0.98), respectively. CONCLUSIONS This study suggested both CTC and MRC with relative higher diagnostic value for diagnosing CRC, while PET/CT with higher diagnostic value in detecting local recurrence for patients with CRC.
Collapse
|
2
|
Usuda K, Iwai S, Yamagata A, Iijima Y, Motono N, Matoba M, Doai M, Yamada S, Ueda Y, Hirata K, Uramoto H. Differentiation between suture recurrence and suture granuloma after pulmonary resection for lung cancer by diffusion-weighted magnetic resonance imaging or FDG-PET / CT. Transl Oncol 2020; 14:100992. [PMID: 33338879 PMCID: PMC7749404 DOI: 10.1016/j.tranon.2020.100992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 12/28/2022] Open
Abstract
There has been no publication which supports the usefulness of DWI differentiating for suture recurrence and suture granuloma after resection for lung cancer. We presented efficacy of DWI or FDG-PET/CT for an assessment of suture lesions after resection for lung cancer. Thirteen suture recurrences and 15 suture granulomas were examined. There were 24 adenocarcinomas and 4 squamous cell carcinomas, and 26 partial resections and 2 segmentectomies. The period of time (907±907 days) between surgery and suture recurrence was not significantly longer than that (546±547 days) between surgery and suture granuloma. Diffusion detectability scores (a 5-point scale) of suture recurrences was significantly higher than that of suture granulomas. The ADC value (1.35±0.24 × 10-3mm2/sec) of suture recurrences was significantly lower than that (1.85±0.60 × 10-3mm2/sec) of suture granulomas. The SUVmax (6.1 ± 5.0) of suture recurrences was not significantly higher than that (4.2 ± 2.5) of suture granulmas. The sensitivity of 85% (11/13) with DWI was not significantly higher than 69% (9/13) with FDG-PET/CT for suture recurrences. The specificity of 73% (11/15) with DWI was not significantly higher than the 60% (9/15) with FDG-PET/CT for suture granulomas. The accuracy of 79% (22/28) with DWI was not significantly higher than that of 64% (18/28) with FDG-PET/CT for suture recurrences and granulomas. DWI can differentiate suture granuloma from suture recurrence after resection of lung cancer. DWI is more useful than FDG-PET/CT for the differentiation between suture recurrence and suture granuloma after resection for lung cancer.
Collapse
Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan.
| | - Shun Iwai
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| | - Aika Yamagata
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| | - Yoshihito Iijima
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| | - Nozomu Motono
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| | - Munetaka Matoba
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| | - Mariko Doai
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| | - Sohsuke Yamada
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| | - Yoshimichi Ueda
- Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| | - Keiya Hirata
- MRI Center, Kanazawa Medical University Hospital, Uchinada, Ishikawa, 920-0293 Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, 920-0293 Japan
| |
Collapse
|
3
|
Pitfalls and value of organ specific approach in evaluating indeterminate lesions detected on CT in colorectal cancer by [F18] FDG PET/CT. Eur J Radiol Open 2020; 7:100264. [PMID: 32939370 PMCID: PMC7479284 DOI: 10.1016/j.ejro.2020.100264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/24/2020] [Indexed: 12/18/2022] Open
Abstract
Objective The objective of this study is to evaluate the value of FDG PET/CT for different involved organs showing Indeterminate/ equivocal / suspicious lesions detected on IV contrasted CT during surveillance follow up for colorectal cancer. Materials and methods A total of 67 patients with colorectal cancer how are on regular surveillance follow up by IV contrasted CT scans revealing indeterminate lesions were studied. Subsequent FDG PET/CT evaluation was performed as a problem solving modality. PET/CT results were statistically characterized when compared to biopsy results or to follow/up results. Also Statistical parameters were calculated for each organ involved. The evaluation of all CT indeterminate lesions by FDG PET/CT showed overall sensitivity of 93%, Specificity of 81%, Negative predictive value of 94%, Positive predictive value 80% and accuracy of 87%. However in an organ specific approach the highest accuracy was for lymph nodes with results showing a 100% accuracy and the lowest accuracy was for local disease at a value of 80%. Probable explanations for the falsely characterized lesions resulting in the pitfalls seen and in the imperfect accuracy were provided. Conclusion Study shows that FDG PET/CT is an excellent tool in characterizing CT indeterminate lesions during surveillance of colorectal cancer, However different organs showed variable accuracy results with the highest accuracy for our study was for lymph node status (100%) and the lowest accuracy being for local disease at the original site of primary tumor (80%).
Collapse
|
4
|
Sobhani I, Itti E, Luciani A, Baumgaertner I, Layese R, André T, Ducreux M, Gornet JM, Goujon G, Aparicio T, Taieb J, Bachet JB, Hemery F, Retbi A, Mons M, Flicoteaux R, Rhein B, Baron S, Cherrak I, Rufat P, Le Corvoisier P, de'Angelis N, Natella PA, Maoulida H, Tournigand C, Durand Zaleski I, Bastuji-Garin S. Colorectal cancer (CRC) monitoring by 6-monthly 18FDG-PET/CT: an open-label multicentre randomised trial. Ann Oncol 2019; 29:931-937. [PMID: 29365058 PMCID: PMC5913635 DOI: 10.1093/annonc/mdy031] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background [18F]2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18FDG-PET/CT) has high sensitivity for detecting recurrences of colorectal cancer (CRC). Our objective was to determine whether adding routine 6-monthly 18FDG-PET/CT to our usual monitoring strategy improved patient outcomes and to assess the effect on costs. Patients and methods In this open-label multicentre trial, patients in remission of CRC (stage II perforated, stage III, or stage IV) after curative surgery were randomly assigned (1 : 1) to usual monitoring alone (3-monthly physical and tumour marker assays, 6-monthly liver ultrasound and chest radiograph, and 6-monthly whole-body computed tomography) or with 6-monthly 18FDG-PET/CT, for 3 years. A multidisciplinary committee reviewed each patient’s data every 3 months and classified the recurrence status as yes/no/doubtful. Recurrences were treated with curative surgery alone if feasible and with chemotherapy otherwise. The primary end point was treatment failure defined as unresectable recurrence or death. Relative risks were estimated, and survival was analysed using the Kaplan–Meier method, log-rank test, and Cox models. Direct costs were compared. Results Of the 239 enrolled patients, 120 were in the intervention arm and 119 in the control arm. The failure rate was 29.2% (31 unresectable recurrences and 4 deaths) in the intervention group and 23.7% (27 unresectable recurrences and 1 death) in the control group (relative risk = 1.23; 95% confidence interval, 0.80–1.88; P = 0.34). The multivariate analysis also showed no significant difference (hazards ratio, 1.33; 95% confidence interval, 0.8–2.19; P = 0.27). Median time to diagnosis of unresectable recurrence (months) was significantly shorter in the intervention group [7 (3–20) versus 14.3 (7.3–27), P = 0.016]. Mean cost/patient was higher in the intervention group (18 192 ± 27 679 € versus 11 131 ± 13 €, P < 0.033). Conclusion 18FDG-PET/CT, when added every 6 months, increased costs without decreasing treatment failure rates in patients in remission of CRC. The control group had very close follow-up, and any additional improvement (if present) would be small and hard to detect. ClinicalTrials.gov identifier NCT00624260
Collapse
Affiliation(s)
- I Sobhani
- EA7375 (EC2M3 Research Team), Université Paris-Est Créteil (UPEC)-Val de Marne, Créteil, France; Department of Gastroenterology, APHP-Hôpital Henri Mondor, Créteil, France.
| | - E Itti
- Department of Nuclear Medicine, APHP-Hôpital Henri Mondor, Créteil, France
| | - A Luciani
- Department of Medical Imaging, APHP-Hôpital Henri Mondor, Créteil, France
| | - I Baumgaertner
- EA7375 (EC2M3 Research Team), Université Paris-Est Créteil (UPEC)-Val de Marne, Créteil, France
| | - R Layese
- Public Health, Unité de Recherche Clinique (URC Mondor), APHP-Hôpital Henri Mondor, Créteil, France; CEpiA Clinical Epidemiology and Ageing Un, EA7376, Université Paris-Est (UPEC), A-TVB DHU, IMRB, Créteil, France
| | - T André
- Sorbonnes University and Department of Medical Oncology, APHP-Hôpital St Antoine, Paris, France
| | - M Ducreux
- Department of Gastrointestinal Oncology, Institut Gustave Roussy, Villejuif, France
| | - J-M Gornet
- Department of Gastroenterology, APHP-Hôpital St Louis, Paris, France
| | - G Goujon
- Department of Gastroenterology, APHP-Hôpital Bichat, Paris, France
| | - T Aparicio
- Department of Gastroenterology, APHP-Hôpital Avicenne, Paris, France
| | - J Taieb
- Department of Gastrointestinal Oncology, APHP-Hôpital Européen Georges Pompidou, Paris, France
| | - J-B Bachet
- Department of Gastroenterology and Medical Informatics, APHP-Hôpital Pitié-Salpêtrière, Paris, France
| | - F Hemery
- Department of Medical Informatics, APHP-Hôpital Henri Mondor, Créteil, France
| | - A Retbi
- Sorbonnes University and Department of Medical Oncology, APHP-Hôpital St Antoine, Paris, France
| | - M Mons
- Department of Gastrointestinal Oncology, Institut Gustave Roussy, Villejuif, France
| | - R Flicoteaux
- Department of Gastroenterology, APHP-Hôpital St Louis, Paris, France
| | - B Rhein
- Department of Medical Informatics, Centre Hospitalier d'Intercommunal de Créteil, Créteil, France
| | - S Baron
- Department of Gastroenterology, APHP-Hôpital Avicenne, Paris, France
| | - I Cherrak
- Department of Gastrointestinal Oncology, APHP-Hôpital Européen Georges Pompidou, Paris, France
| | - P Rufat
- Department of Gastroenterology and Medical Informatics, APHP-Hôpital Pitié-Salpêtrière, Paris, France
| | - P Le Corvoisier
- Clinical Investigations Centre, APHP-Hôpital Henri Mondor, Créteil, France
| | - N de'Angelis
- EA7375 (EC2M3 Research Team), Université Paris-Est Créteil (UPEC)-Val de Marne, Créteil, France
| | - P-A Natella
- Public Health, Unité de Recherche Clinique (URC Mondor), APHP-Hôpital Henri Mondor, Créteil, France
| | - H Maoulida
- Healthcare Economics Research Unit, APHP, Paris, France, France
| | - C Tournigand
- EA7375 (EC2M3 Research Team), Université Paris-Est Créteil (UPEC)-Val de Marne, Créteil, France
| | | | - S Bastuji-Garin
- Public Health, Unité de Recherche Clinique (URC Mondor), APHP-Hôpital Henri Mondor, Créteil, France; CEpiA Clinical Epidemiology and Ageing Un, EA7376, Université Paris-Est (UPEC), A-TVB DHU, IMRB, Créteil, France
| |
Collapse
|
5
|
Use of semiquantitative analysis in local recurrence of colorectal carcinoma with 18F-FDG PET/CT: A myth or a truth? Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2018.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
6
|
Use of semiquantitative analysis in local recurrence of colorectal carcinoma with 18F-FDG PET/CT: A myth or a truth? Rev Esp Med Nucl Imagen Mol 2018; 37:366-372. [PMID: 30193775 DOI: 10.1016/j.remn.2018.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Recurrence of colorectal cancer is mostly seen within the first 2 years after surgery. The most frequent site of recurrence is the postsurgical areas and its surroundings. The purpose of this study was to evaluate the usefulness of semiquantitative analysis of 18Fluorine fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in determining recurrence of colorectal carcinoma in the operation site. MATERIAL AND METHODS Files of 35 patients with colorectal carcinoma (25 men, 10 women, mean age: 59.25±2.82 years, range: 27-80 years) who were treated with surgery and underwent FDG PET/CT scanning for restaging of colorectal carcinoma and showing increased FDG uptake in the postsurgical area, were retrospectively analysed. Besides calculating SUVmax of the areas showing FDG uptake, SUVmax of physiological colonic activity was also obtained and SUVmax of lesion/SUVmax of colonic wall (RSUVmax), was calculated. Characteristics of FDG uptake were classified according to histological analysis or clinical and imaging follow-up. RESULTS In 17 of 35 patients (49%) the standard of reference for the final diagnosis was histologic analysis and in 18 (51%), final diagnosis was based on imaging and clinical follow-up. In 15 of 35 patients (43%) the etiology of increased FDG uptake was recurrence and in 20 (57%), FDG accumulation was observed due to benign etiology. The difference between the mean of the results of SUVmax in patients with recurrent disease and with no evidence of recurrence was statistically significant (P=.030). For SUVmax, a cut-off value for recurrence was calculated as 9.51 with a sensitivity of 80% and a specificity of 70%. In terms of RSUVmax results, a statistically significant difference was also observed between mean values in patients with recurrent disease and in those without (P=.002). ROC analysis demonstrated that the best predictive value of RSUVmax for recurrence was 1.75 with a sensitivity of 67% and specificity of 95%. CONCLUSIONS Semiquantitative analysis of FDG PET/CT may be used in detecting recurrent disease of patients with colorectal carcinoma. Eliminating interfering physiological colonic activity in analysis may have an incremental effect on the success of this technique, by means of increasing the specificity.
Collapse
|
7
|
Moomjian LN, Clayton RD, Carucci LR. A Spectrum of Entities That May Mimic Abdominopelvic Abscesses Requiring Image-guided Drainage. Radiographics 2018; 38:1264-1281. [PMID: 29995617 DOI: 10.1148/rg.2018170133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A variety of entities may mimic drainable abscesses. This can lead to misdiagnosis of these entities, unnecessary percutaneous placement of a pigtail drainage catheter, other complications, and delay in appropriate treatment of the patient. Types of entities that may mimic drainable abscesses include neoplasms (lymphoma, gallbladder cancer, gastrointestinal stromal tumor, ovarian cancer, mesenteric fibromatosis, ruptured mature cystic teratoma, recurrent malignancy in a surgical bed), ischemia/infarction (liquefactive infarction of the spleen, infarcted splenule), diverticula (calyceal, Meckel, and giant colonic diverticula), and congenital variants (obstructed duplicated collecting system). Postoperative changes, including expected anatomy after urinary diversion or Roux-en-Y gastric bypass and small bowel resection, may also pose a diagnostic challenge. Nonpyogenic infections (Mycobacterium tuberculosis, Mycobacterium avium complex, echinococcal cysts) and inflammatory conditions such as xanthogranulomatous pyelonephritis and gossypiboma could also be misinterpreted as drainable fluid collections. Appropriate recognition of these entities is essential for optimal patient care. This article exposes radiologists to a variety of entities for which percutaneous drainage may be requested, but is not indicated, and highlights important imaging findings associated with these entities to facilitate greater diagnostic accuracy and treatment in their practice. ©RSNA, 2018.
Collapse
Affiliation(s)
- Lauren N Moomjian
- From the Department of Radiology, Virginia Commonwealth University Medical Center, 1250 E Marshall St, PO Box 980615, Richmond, VA 23298
| | - Ryan D Clayton
- From the Department of Radiology, Virginia Commonwealth University Medical Center, 1250 E Marshall St, PO Box 980615, Richmond, VA 23298
| | - Laura R Carucci
- From the Department of Radiology, Virginia Commonwealth University Medical Center, 1250 E Marshall St, PO Box 980615, Richmond, VA 23298
| |
Collapse
|
8
|
Prospective Trial Evaluating the Surgical Anastomosis at One-Year Colorectal Cancer Surveillance: CT Colonography Versus Optical Colonoscopy and Implications for Patient Care. Dis Colon Rectum 2017; 60:1162-1167. [PMID: 28991080 PMCID: PMC5635837 DOI: 10.1097/dcr.0000000000000845] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of this study was to compare the accuracy of CT colonography versus optical colonoscopy for neoplastic involvement at the surgical anastomosis 1 year after curative-intent colorectal cancer resection. DESIGN, SETTING, PATIENTS, AND INTERVENTIONS Two hundred one patients (mean age, 58.6 years; 117 men, 84 women) underwent same-day contrast-enhanced CT colonography and colonoscopy approximately 1 year (mean, 12.1 months; median, 11.9 months) after colorectal cancer resection as part of a prospective, multicenter trial. All patients enrolled were without clinical evidence of disease and considered low risk for recurrence (stage I-III). MAIN OUTCOME MEASURES Suspected neoplastic lesions within 5 cm of the colonic anastomosis were recorded at CT colonography, with subsequent colonoscopy performed for the same, with segmental unblinding of colonography findings. Anastomotic region biopsy or polypectomy was performed at the endoscopist's discretion. RESULTS None of the 201 patients had intraluminal anastomotic cancer recurrence or advanced neoplasia (or metachronous cancers). CT colonography detected extramural perianastomotic recurrence in 2 patients (1.0%); neither was detected at colonoscopy. Only 2 patients (1.0%; 2/201) were called positive at CT colonography for intraluminal anastomotic nondiminutive lesions (7- to 8-mm polyps), which were confirmed at colonoscopy but nonneoplastic at histopathology. At optical colonoscopy, the anastomosis was deemed abnormal and/or biopsied in 10.0% (20/201), yielding only 1 nondiminutive benign neoplasm (7-mm tubular adenoma). LIMITATIONS The lack of luminal cancer recurrence in our lower-risk cohort precludes assessment of sensitivity for detection, rendering the study underpowered in this regard. Potential cost savings of combined CT/CT colonography over the standard CT/colonoscopy approach were not assessed. CONCLUSIONS Relevant intraluminal anastomotic pathology appears to be very uncommon 1 year after colorectal cancer resection in lower-risk cohorts. Unlike colonoscopy, diagnostic contrast-enhanced CT colonography effectively evaluates both the intra- and extraluminal aspects of the anastomosis. See Video Abstract at http://links.lww.com/DCR/A471.
Collapse
|
9
|
Garg G, Benchekroun MT, Abraham T. FDG-PET/CT in the Postoperative Period: Utility, Expected Findings, Complications, and Pitfalls. Semin Nucl Med 2017; 47:579-594. [PMID: 28969758 DOI: 10.1053/j.semnuclmed.2017.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
FDG-PET/CT as a modality is increasingly used for detection of recurrence and for restaging in patients with clinical suspicion of malignancy, as well as in patients with elevated tumor markers. However, there are many pitfalls in the interpretation of these scans when the studies are performed after some treatment. Some of these are attributed to normal physiological distribution and are compounded when there are inflammatory changes occurring after surgery. The body's inherent response to the surgical insult results in this inflammation. In addition, there are also complications that can happen following surgery, causing increased FDG uptake. Despite various fallacies, FDG-PET/CT provides valuable information in evaluation of residual and recurrent malignant disease. In this article, we aim to describe some of these postsurgical changes secondary to inflammation, common surgical complications, and finally, the utility of FDG-PET/CT in these patients to detect recurrent disease, even in the background of postsurgical changes.
Collapse
Affiliation(s)
- Gunjan Garg
- Division of Nuclear Medicine, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Mohammed Taoudi Benchekroun
- Division of Nuclear Medicine, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Tony Abraham
- Division of Nuclear Medicine, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
| |
Collapse
|
10
|
Visual and quantitative comparison of (18)F-fluorodeoxyglucose PET/CT findings in the detection of pelvic tumor recurrence in colorectal cancer. Ann Nucl Med 2016; 30:355-61. [PMID: 26931104 DOI: 10.1007/s12149-016-1069-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to visually and quantitatively compare (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) imaging in determining postoperative pelvic recurrence in colorectal cancer (CRC). MATERIALS AND METHODS This retrospective analysis focused on 96 patients (age: mean 62.6 ± 10.5) with surgically resected CRC (time interval after surgery: 19.2 ± 20.4 months). The standard of reference was histopathologic confirmation (n = 27) or imaging follow-up (n = 69). For visual analysis, three independent nuclear physicians interpreted the PET/CT findings. For the quantitative analysis, the normalized standardized uptake values (nSUVs: nSUVmax, nSUVpeak, nSUVmean) were calculated by applying the mean SUV of a normal liver. We evaluated the areas under the receiver operating characteristic curves (AUCs) for all the quantitative parameters. RESULTS Of the 96 patients, 49 showed pelvic recurrence and 47 revealed no tumor recurrence. Sensitivity and specificity were 85.7 and 80.9 %, respectively, for visual analysis, and 65.3 and 83.0 %, respectively, for quantitative analysis. The AUC (0.766, CI: 0.668-0.846) of nSUVmax was largest comparing nSUVpeak and nSUVmean values, without significant difference (p value >0.316). Sensitivity of lesion detection was superior in visual analysis (p value = 0.02), but specificity was not significantly different (p = 0.80). After inclusive and exclusive combinations, sensitivity and specificity were slightly increased to 89.8 % (p = 0.54) and 91.5 % (p = 0.14), respectively. CONCLUSIONS Visual interpretation was superior to quantitative analysis in pelvic tumor recurrence in CRC. Though it was possible to improve diagnostic performance through combinatory analysis, the effect was not statistically significant.
Collapse
|
11
|
|
12
|
Diagnostic Value of 18F-FDG PET/CT in Detecting Local Recurrent Colorectal Cancer: A Pooled Analysis of 26 Individual Studies. Cell Biochem Biophys 2015; 72:443-51. [DOI: 10.1007/s12013-014-0485-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
13
|
Abstract
OBJECTIVE CT remains the imaging modality of choice in the diagnosis of colorectal cancer (CRC) and anal cancer. However, advances in imaging have expanded the role of MRI and PET/CT. This article focuses on the evolving role of FDG PET/CT in the diagnosis, radiation therapy planning, therapy assessment, and posttherapy monitoring of CRC and anal cancer. CONCLUSION FDG PET/CT is a valuable imaging modality that impacts the clinical management of patients with CRC and those with anal cancer.
Collapse
|
14
|
Shinagare A, Shyn P, Sadow C, Wasser E, Catalano P. Incidence, appropriateness, and consequences of recommendations for additional imaging tests in oncological PET/CT reports. Clin Radiol 2013; 68:155-61. [DOI: 10.1016/j.crad.2012.06.111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 06/14/2012] [Accepted: 06/25/2012] [Indexed: 01/08/2023]
|
15
|
Liong SY, Kochhar R, Renehan AG, Manoharan P. Utility of 18-fluorodeoxyglucose positron emission/computed tomography in the management of recurrent colorectal cancer. ANZ J Surg 2012; 82:729-36. [DOI: 10.1111/j.1445-2197.2012.06237.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2011] [Indexed: 11/30/2022]
Affiliation(s)
- Sue Y. Liong
- Department of Clinical Radiology; The Christie; Manchester; UK
| | - Rohit Kochhar
- Department of Clinical Radiology; The Christie; Manchester; UK
| | | | | |
Collapse
|
16
|
Soussan M, Rust E, Pop G, Morère JF, Brillet PY, Eder V. The rim sign: FDG-PET/CT pattern of pulmonary infarction. Insights Imaging 2012; 3:629-33. [PMID: 22903456 PMCID: PMC3505564 DOI: 10.1007/s13244-012-0189-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 07/25/2012] [Accepted: 07/26/2012] [Indexed: 01/12/2023] Open
Abstract
Objective We aimed to describe a pattern of rim uptake observed in lung infarction on FDG-PET/CT, called the “rim sign.” It was defined as a continuous slight FDG uptake along the border of a subpleural consolidation without uptake within the consolidation. Methods We retrospectively reviewed the FDG-PET/CT studies of 400 patients referred for thoracic oncological workup from November 2010 to July 2011. The rim sign was observed in six patients who had confirmed pulmonary infarction (PI) on MDCT showing acute pulmonary embolism (n = 4) or tumoral arterial obstruction (n = 2). Results Eight PIs in the six patients exhibited the rim sign with slight uptake (median SUVmax: 3.6, 2.2–6.8) and median size of 48.5 mm (30–74). On MDCT, central lucencies, triangular shape and vessel sign were observed in 5/8, 4/8 and 1/8 cases, respectively. Two out of the eight PIs exhibited only the rim sign and none the suggestive MDCT sign. Conclusion The rim sign is easily recognisable at FDG-PET/CT and is strongly suggestive of PI. This pattern can be observed even in the absence of suggestive findings on MDCT. Recognition of this sign should prompt investigations for pulmonary embolism. Main Messages • The rim sign is a slight FDG uptake around an area of subpleural consolidation • The rim sign is strongly suggestive of pulmonary infarction • Recognition of the rim sign should prompt investigations for pulmonary embolism
Collapse
Affiliation(s)
- Michael Soussan
- AP-HP, Department of Nuclear Medicine, Avicenne hospital, University Paris 13, Bobigny, France,
| | | | | | | | | | | |
Collapse
|
17
|
Purandare NC, Dua SG, Arora A, Shah S, Rangarajan V. Colorectal cancer - patterns of locoregional recurrence and distant metastases as demonstrated by FDG PET / CT. Indian J Radiol Imaging 2011; 20:284-8. [PMID: 21423904 PMCID: PMC3056626 DOI: 10.4103/0971-3026.73545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Colorectal cancer (CRC) can recur locoregionally or at distant sites. Timely diagnosis of recurrence is of paramount importance, as radical treatment of the localized disease can prolong survival. Fluorodeoxyglucose positron emission tomography / computed tomography (PET / CT) is routinely used in restaging and surveillance of colorectal cancer, as it can demonstrate recurrent disease with good accuracy. This article illustrates the spectrum of standard as well as unusual patterns of local recurrence and distant metastases of colorectal cancer.
Collapse
Affiliation(s)
- Nilendu C Purandare
- Bio-Imaging Unit, Tata Memorial Hospital, Dr. Ernest Borges Marg, Parel, Mumbai- 400 012, India
| | | | | | | | | |
Collapse
|
18
|
|