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Ma W, Chen B, Zhu F, Yang C, Yang J. Diagnostic role of F-18 FDG PET/CT in determining preoperative Lymph node status of patients with rectal cancer: a meta-analysis. Abdom Radiol (NY) 2024; 49:2125-2134. [PMID: 38281158 DOI: 10.1007/s00261-023-04140-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE To obtain performance values of PET/CT for determining the nodal status of rectal cancer. MATERIALS A comprehensive literature search was performed on PubMed and Embase for original diagnostic accuracy studies on the diagnostic performance of PET-CT for detection of LN metastasis in rectal cancer. The QUADAS-2 was used to evaluate the methodological quality of each study. Pooled sensitivity, specificity, and AUC were calculated to estimate the diagnostic role of PET/CT using a random-effects model. A subgroup analysis was performed to investigate the influence of different parameters on diagnostic performance. RESULTS A total of 15 studies and 1209 patients were included. A publication bias was observed. The pooled sensitivity, specificity, and AUC for PET/CT was 0.62 (95% CI 0.49, 0.74), 0.94 (95% CI 0.87, 0.97), and 0.87 (95% CI 0.83-0.89), respectively. Per-node basis yields higher accuracy than per-patient basis, with pooled sensitivities of 0.65 (95% CI 0.50-0.79) vs. 0.56 (95% CI 0.36-0.77) and specificities of 0.96 (95% CI 0.92-1.00) vs. 0.88 (95% CI 0.76-1.00), but there were no significant differences in diagnostic accuracy. CONCLUSION PET/CT has high specificity but moderate sensitivity for the detection of LN metastasis in rectal cancer. The current data suggests that the diagnostic capabilities of this method is limited due to its moderate sensitivity.
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Affiliation(s)
- Weili Ma
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Bo Chen
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Fandong Zhu
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Chen Yang
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Jianfeng Yang
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China.
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Ryu HS, Kim HJ, Ji WB, Kim BC, Kim JH, Moon SK, Kang SI, Kwak HD, Kim ES, Kim CH, Kim TH, Noh GT, Park BS, Park HM, Bae JM, Bae JH, Seo NE, Song CH, Ahn MS, Eo JS, Yoon YC, Yoon JK, Lee KH, Lee KH, Lee KY, Lee MS, Lee SH, Lee JM, Lee JE, Lee HH, Ihn MH, Jang JH, Jeon SK, Chae KJ, Choi JH, Pyo DH, Ha GW, Han KS, Hong YK, Hong CW, Kwak JM. Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment. Ann Coloproctol 2024; 40:89-113. [PMID: 38712437 PMCID: PMC11082542 DOI: 10.3393/ac.2024.00059.0008] [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: 01/20/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 05/08/2024] Open
Abstract
Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients' values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.
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Affiliation(s)
- Hyo Seon Ryu
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Institute for Evidence-based Medicine, Cochrane Collaboration, Seoul, Korea
| | - Woong Bae Ji
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Ansan Hospital, Ansan, Korea
| | - Byung Chang Kim
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Ji Hun Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Kyung Moon
- Department of Radiology, Kyung Hee University Hospital, Seoul, Korea
| | - Sung Il Kang
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
| | - Han Deok Kwak
- Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Eun Sun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Chang Hyun Kim
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Tae Hyung Kim
- Department of Radiation Oncology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Gyoung Tae Noh
- Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
| | - Byung-Soo Park
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyeung-Min Park
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Jeong Mo Bae
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
| | - Jung Hoon Bae
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ni Eun Seo
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Hoon Song
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi Sun Ahn
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine and Molecular Imaging, Korea University College of Medicine, Seoul, Korea
| | - Young Chul Yoon
- Department of General Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
| | - Kyung Ha Lee
- Department of Surgery, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kyung Hee Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kil-Yong Lee
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Myung Su Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Sung Hak Lee
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Min Lee
- Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Ji Eun Lee
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Han Hee Lee
- Division of Gastroenterology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myong Hoon Ihn
- Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Je-Ho Jang
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Sun Kyung Jeon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Kum Ju Chae
- Department of Radiology, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jin-Ho Choi
- Center for Lung Cancer, Department of Thoracic Surgery, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Dae Hee Pyo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gi Won Ha
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Kyung Su Han
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Young Ki Hong
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Chang Won Hong
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Jung-Myun Kwak
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Korean Colon Cancer Multidisciplinary Committee
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Institute for Evidence-based Medicine, Cochrane Collaboration, Seoul, Korea
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Ansan Hospital, Ansan, Korea
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Radiology, Kyung Hee University Hospital, Seoul, Korea
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
- Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
- Department of Radiation Oncology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
- Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
- Department of Nuclear Medicine and Molecular Imaging, Korea University College of Medicine, Seoul, Korea
- Department of General Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
- Department of Surgery, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
- Division of Gastroenterology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
- Department of Radiology, Jeonbuk National University Medical School, Jeonju, Korea
- Center for Lung Cancer, Department of Thoracic Surgery, Research Institute and Hospital, National Cancer Center, Goyang, Korea
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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3
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Gauci CM, Kim TJ, Gao Y, Perera DS. Accuracy of pre-operative 18-fluoride fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting lymph node involvement in colon cancer. ANZ J Surg 2023; 93:2675-2679. [PMID: 37530228 DOI: 10.1111/ans.18637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Accurate staging of colon cancer is imperative in directing treatment and prognostication. Existing literature on pre-operative accuracy of FDG-PET/CT in detecting lymph node disease often combines colon and rectal cancer, examines rectal cancers alone, and rarely assesses colon cancer in isolation. Our aim was to assess pre-operative utility of FDG-PET/CT in detecting lymph node disease in colon cancer. METHODS A retrospective cohort analysis was performed at a single Australian institution between 2017 and 2022 to identify treatment naive primary colonic tumours. Primary outcome was sensitivity and specificity using formal surgical histopathology as gold standard. Secondary outcomes were patient and tumour factors predictive of FDG-PET/CT positive disease including pre-operative CEA, mismatch repair status, duration to surgery, and tumour T-stage. RESULTS Three hundred and thirty-nine patients were identified. Thirty-four had pre-operative FDG-PET/CT without neoadjuvant therapy. The mean surgical lymph node harvest was 18 nodes. Twenty-five patients had moderately differentiated tumours. The median duration between FDG-PET/CT and operation was 17 days. Pre-operative FDG-PET/CT suggested positive lymph node involvement in 12 patients. Compared to final lymph node histopathology, FDG-PET/CT had a sensitivity of 53%, specificity of 82%, positive predictive value of 75%, negative predictive value of 64% and accuracy of 68%. There was no significant difference between groups for secondary outcomes. CONCLUSION FDG-PET/CT has moderate specificity but poor sensitivity in the detection of lymph node involvement in colon cancer. Its utility should likely remain isolated to investigating equivocal lesions or follow up of known PET avid disease.
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Affiliation(s)
- Chahaya Marc Gauci
- Department Colorectal Surgery, St George Hospital, Sydney, New South Wales, Australia
- St George & Sutherland Campus, School of Clinical Medicine, UNSW Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tae Jun Kim
- Department Colorectal Surgery, St George Hospital, Sydney, New South Wales, Australia
- Liverpool Hospital Campus, School of Clinical Medicine, UNSW Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Yijun Gao
- Department Colorectal Surgery, St George Hospital, Sydney, New South Wales, Australia
- St George & Sutherland Campus, School of Clinical Medicine, UNSW Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Dayashan S Perera
- Department Colorectal Surgery, St George Hospital, Sydney, New South Wales, Australia
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4
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Soyluoglu S, Ozdemir Gunay B. Contribution of Metabolic Parameters and Pericolic Fat Stranding on Preoperative 18F-FDG PET/CT in Predicting Post-operative Histopathology and Outcome in Colorectal Cancer. Nucl Med Mol Imaging 2023; 57:223-234. [PMID: 37720878 PMCID: PMC10504194 DOI: 10.1007/s13139-023-00808-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 09/19/2023] Open
Abstract
Purpose We aimed to investigate the additional value of preoperative PET/CT and reveal relationships between metabolic parameters, pericolic fat stranding finding, postoperative histopathology, and overall survival in colorectal cancer (CRC). Methods CRC patients who underwent preoperative PET/CT between January 2017-December 2021 were analyzed. Lymph nodes, organ metastases, and metabolic parameters were evaluated from PET/CT. The pericolic fat stranding was evaluated from CT component. Relationships between these factors and postoperative histopathological findings were statistically analyzed. Survival analyses were performed. Results Ninety-one patients (59 males, 32 females) were included in the study. All tumors showed high FDG uptake (mean SUVmax 19.5 ± 9.9). SUVmax of the tumor differed significantly at T3 and T4 stages (p = 0.041). A significant correlation was found between MTV, TLG values and the differentiation degree (p = 0.005, 0.003, respectively). PET/CT predicted the N stage with a high accuracy rate (80%). PET/CT found additional metastases that changed treatment decisions in one-third of patients. A relationship was found between tumor length, surgical margin, lymphovascular invasion and pericolic fat stranding. In multivariate analysis, differentiation degree (HR = 26.1, 95%CI 1.672-408.467), MTV (HR = 0.3, 95%CI 0.071-0.841), TLG (HR = 3.5, 95%CI 1.065-11.193), and lymphovascular invasion (HR = 0.2, 95%CI 0.026-0.853, p = 0.033) were independent factors affecting overall survival. Conclusion Preoperative PET/CT contributes to CRC management by detecting additional metastases as well as predicting prognosis and postoperative findings such as T stage, N stage and tumor differentiation. The SUVmax may differentiate between T3 and T4 tumor. Reporting of pericolic fat stranding may contribute to the estimation of lymphatic invasion and positive surgical margin.
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Affiliation(s)
- Selin Soyluoglu
- Faculty of Medicine, Department of Nuclear Medicine, Trakya University, Balkan Yerleskesi Trakya Üniversitesi Tıp Fakultesi Nukleer Tıp AD, Edirne, 22030 Turkey
| | - Busra Ozdemir Gunay
- Faculty of Medicine, Department of Nuclear Medicine, Trakya University, Balkan Yerleskesi Trakya Üniversitesi Tıp Fakultesi Nukleer Tıp AD, Edirne, 22030 Turkey
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5
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Wetterholm E, Rosén R, Rahman M, Rönnow CF. CT is unreliable in locoregional staging of early colon cancer: A nationwide registry-based study. Scand J Surg 2023; 112:33-40. [PMID: 36377769 DOI: 10.1177/14574969221132648] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVE The option to treat early colon cancer (CC) with local resection, as well as trials investigating neoadjuvant treatment, has increased the importance of identifying early-stage disease in the workup. Most CC patients are T- and N-staged preoperatively with CT, although its reliability in staging early CC remains elusive. The aim of this study was to investigate CT-staging accuracy in early CC by evaluating pT and pN stages in patients staged as cT1-2, and cT and cN stages in patients with pT1 tumors. METHODS Retrospective population-based cohort study on data from the nationwide Swedish colorectal cancer registry on all CC patients staged as cT1-2 and all patients with pT1 undergoing surgical resection 2009-2018. CT-acquired T- and N-stages were compared with final histopathology. Factors potentially influencing accuracy were analyzed with uni- and multivariate logistic regression. RESULTS Computed tomography (CT) staged 4849 patients as cT1-2, whereas 2445 (50%) were pT3 and 453 (9%) pT4. Positive predictive value of the cT1-2 stage was 40%. Of 1401 pT1 patients, 624 (45%) were staged as cT1-2, 139 (10%) as cT3, 15 (1%) as cT4 and 623 (44%) as cTx. In all, 1474 (30%) of the cT1-2 patients were pN+, whereas CT staged 1062 (72%) as cN0. A total of 771 patients were staged as cN+, whereas 403 (52%) were pN0. Overall accuracy in determining N+ was 67%, with 26% sensitivity and 88% specificity. Positive and negative predictive values in determining N+ were 48% and 73%, respectively. CONCLUSIONS This nationwide population-based study shows that CT-staging carries a substantial risk of understaging locally advanced tumors as cT1-2 and pT1 tumors as cTx, in addition to poor N-staging. Thus, CT obtained T- and N-staging should not be used for deciding treatment strategies in early CC.
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Affiliation(s)
- Erik Wetterholm
- Section of Surgery, Department of Clinical Sciences, Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Roberto Rosén
- Section of Surgery, Department of Clinical Sciences, Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Milladur Rahman
- Section of Surgery, Department of Clinical Sciences, Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Carl-Fredrik Rönnow
- Section of Surgery Department of Clinical Sciences, Malmö Skåne University Hospital Lund University 20502 Malmö Sweden
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Liu D, Sun LM, Liang JH, Song L, Liu XP. Diagnostic accuracy of ≥ 16-slice spiral computed tomography for local staging of colon cancer: A systematic review and meta-analysis. World J Clin Cases 2022; 10:6483-6495. [PMID: 35979307 PMCID: PMC9294879 DOI: 10.12998/wjcc.v10.i19.6483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/24/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity, although colon cancer and rectal cancer have largely different diagnoses, treatments, surgical methods, and recurrence rates. ≥ 16-slice spiral computed tomography (SCT) is mostly applied to detect the local stage of colon cancer; however, its diagnostic accuracy and whether it is conducive to distinguishing between high-risk and low-risk colon cancer are unclear.
AIM To systematically review the diagnostic accuracy of ≥ 16-slice SCT for local staging of colon cancer.
METHODS Based on the PubMed, EMBASE, Cochrane Library, and Web of Science databases, computers were used to search the literature from the establishment of the database to April 2021, and the results of the diagnostic tests on ≥ 16-slice SCT for local staging of colon cancer were collected according to the inclusion criteria. The data were then extracted and assessed on the basis of the Quality Assessment Checklist of the Institute of Economics of Canada, Reference Citation Analysis (https://www.referencecitationanalysis.com/). Afterward, a meta-analysis was performed using the statistical software Meta-disc 14.0 and Stata 15.0.
RESULTS Eleven studies that provided data on 1613 subjects with computed tomography diagnostic tests were included in this study. Meta-analysis revealed that the pooled sensitivity, pooled specificity, pooled negative likelihood ratio (LR), pooled diagnostic odds ratio, and area under the fitted receiver operating characteristic (ROC) curve of ≥ 16-slice SCT for colon cancer T staging were 0.67 (95%CI: 0.65-0.70), 0.81 (95%CI: 0.80-0.83), 4.13 (95%CI: 2.66-6.41), 0.39 (95%CI: 0.31-0.49), 10.81 (95%CI: 7.33-15.94), and 0.829, respectively, while the specificity, negative LR, diagnostic odds ratio, and area under the fitted ROC curve of ≥ 16-slice SCT for N staging of colon cancer were 0.54 (95%CI: 0.49-0.59), 0.74 (95%CI: 0.70-0.77), 1.92 (95%CI: 1.36-2.70), 0.67 (95%CI: 0.51-0.87), 3.74 (95%CI: 1.76-7.94), and 0.829 respectively. The sensitivity and specificity of ≥ 16-slice SCT for colon cancer T staging were acceptable, while the sensitivity for colon cancer N staging was relatively low, though its specificity was acceptable.
CONCLUSION ≥ 16-slice SCT for local staging of colon cancer has good diagnostic value; however, the accuracy needs to be confirmed by further clinical practice.
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Affiliation(s)
- Dan Liu
- Xi’an Hospital of Traditional Chinese Medicine, Xi’an 710021, Shaanxi Province, China
| | - Lin-Mei Sun
- Xi’an Hospital of Traditional Chinese Medicine, Xi’an 710021, Shaanxi Province, China
| | - Jing-Hua Liang
- Shenzhen Traditional Chinese Medicine Anorectal Hospital, Shenzhen 518000, Guangdong Province, China
| | - Lei Song
- Xi’an Hospital of Traditional Chinese Medicine, Xi’an 710021, Shaanxi Province, China
| | - Xiao-Pei Liu
- School of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang 710021, Shaanxi Province, China
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Abstract
International colon cancer guidelines suggest F-FDG PET/CT in a few circumstances: (1) at disease presentation in case of suspected or proven metastatic synchronous adenocarcinoma; (2) in the workup of recurrent colon cancer with metachronous metastases documented by CT, MRI, or biopsy and in case of serial CEA elevation with negative colonoscopy and negative CT; and (3) in case of contraindication to iodine- and gadolinium-based contrast agents. However, review of the literature has shown that PET/CT can also be used in other scenarios with significant levels of diagnostic advantage. This review aims to emphasize differences between guidelines and scientific literature for the use of PET/CT in colon cancer.
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Cai-Xia W, Rong-Fu W. Clinical application and research advancement of positron emission tomography/computed tomography in colorectal cancer. Shijie Huaren Xiaohua Zazhi 2020; 28:925-932. [DOI: 10.11569/wcjd.v28.i18.925] [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] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer is one of the most common malignant tumors of the digestive system. Early diagnosis and accurate staging and restaging of tumors are the preconditions for standardized treatment of colorectal cancer, which is conducive to the selection of treatment options and the evaluation of prognosis, as well as the improvement of patients' quality of life. With the popularization of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT), its value in the diagnosis, staging and restaging, treatment decision-making, and efficacy and prognosis assessment of colorectal cancer is becoming increasingly important. This review briefly introduces the application and advancement of PET/CT in the diagnosis and treatment of colorectal cancer, in the hope that clinicians can have a more comprehensive understanding of the significance of PET/CT in the diagnosis and treatment of colorectal cancer.
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Affiliation(s)
- Wu Cai-Xia
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Wang Rong-Fu
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China,Department of Nuclear Medicine, Peking University International Hospital, Beijing 102206, China
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9
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Abstract
Molecular imaging with positron emission tomography (PET) using tumour-seeking radiopharmaceuticals has gained wide acceptance in oncology with many clinical applications. The hybrid imaging modality PET/CT (computed tomography) allows assessing molecular as well as morphologic information at the same time. Therefore, PET/CT represents an efficient tool for whole-body staging and re-staging within one imaging modality. In oncology, the glucose analogue 18-F-fluorodeoxyglucose (FDG) is the most widely used PET/CT radiopharmaceutical in clinical routine. FDG PET and FDG PET/CT have been used for staging and re-staging of tumour patients in numerous studies. This chapter will discuss the use and the main indications of FDG PET/CT in oncology with special emphasis on lung cancer, lymphoma, head and neck cancer, melanoma and breast cancer (among other tumour entities). A review of the current literature is given with respect to primary diagnosis, staging and diagnosis of recurrent disease. Besides its integral role in diagnosis, staging and re-staging of disease in oncology, there is increasing evidence that FDG PET/CT can be used for therapy response assessment (possibly influencing therapeutic management and treatment planning) by evaluating tumour control, which will also be discussed in this chapter.
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Affiliation(s)
- Juliane Becker
- Department of Nuclear Medicine, University Medicine Rostock, Gertrudenplatz 1, 18057, Rostock, Germany
| | - Sarah M Schwarzenböck
- Department of Nuclear Medicine, University Medicine Rostock, Gertrudenplatz 1, 18057, Rostock, Germany
| | - Bernd J Krause
- Department of Nuclear Medicine, University Medicine Rostock, Gertrudenplatz 1, 18057, Rostock, Germany.
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Rollvén E, Blomqvist L, Öistämö E, Hjern F, Csanaky G, Abraham-Nordling M. Morphological predictors for lymph node metastases on computed tomography in colon cancer. Abdom Radiol (NY) 2019; 44:1712-1721. [PMID: 30767041 DOI: 10.1007/s00261-019-01900-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION/BACKGROUND The aim of the study was to assess morphological predictors for lymph node metastases (Stage III disease) in colon cancer on computed tomography. METHODS AND MATERIALS Ninety-four patients with histology-proven colon cancer (adenocarcinoma) who underwent elective primary curative resection between the years 2012 and 2014 were included. Contrast-enhanced CT examinations were independently reviewed by two blinded observers regarding tumor location, depth of tumor invasion, and presence of lymph node metastases. Ocular presence of internal heterogeneity and presence of irregular outer border were used as morphological criteria for lymph node involvement. Protocol-based histopathology after curative surgery served as reference standard. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy for each morphological criterion for prediction of stage III disease were calculated. Inter-observer agreement was compared using Kappa statistics. RESULTS According to histopathology, 59 patients were staged as I-II disease and 35 patients were staged as stage III disease. The presence of internal heterogeneity in a lymph node on CT resulted in moderate sensitivity (66-77%) but high specificity (95-95%) for prediction of Stage III disease by both observers. The presence of irregular outer border also resulted in poor sensitivity (49-54%) but high specificity (97-97%). The combination of either internal heterogeneity and/or irregular outer border per patient resulted in a moderate sensitivity (67-77%) and high specificity (95-95%), PPV (89-96%), and NPV (84-88%). Inter-observer agreement (Cohens Kappa) was 0.72. Consensus reading for the combined criteria resulted in sensitivity and specificity of 69% and 100%, respectively. CONCLUSION Using morphological criteria for lymph node metastases on CT examination in patients with colon cancer results in high specificity but moderate sensitivity in predicting stage III disease.
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Affiliation(s)
- Erik Rollvén
- Department of Molecular Medicine and Surgery Karolinska Institutet, Department of Radiology, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden.
| | - Lennart Blomqvist
- Department of Molecular Medicine and Surgery Karolinska Institutet, Department of Radiology, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden
| | - Emma Öistämö
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Hjern
- Department of Clinical Sciences, Karolinska Institutet, Division of Surgery, Danderyd Hospital, Stockholm, Sweden
| | - György Csanaky
- Department of Pathology and Clinical Cytology, Karolinska University Hospital, Stockholm, Sweden
| | - Mirna Abraham-Nordling
- Department of Molecular Medicine and Surgery Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
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Kitajima K, Nakajo M, Kaida H, Minamimoto R, Hirata K, Tsurusaki M, Doi H, Ueno Y, Sofue K, Tamaki Y, Yamakado K. Present and future roles of FDG-PET/CT imaging in the management of gastrointestinal cancer: an update. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 79:527-543. [PMID: 29238109 PMCID: PMC5719212 DOI: 10.18999/nagjms.79.4.527] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Positron emission tomography/computed tomography (PET/CT) integrated with 2-[18F]fluoro-2-deoxy-D-glucose (FDG) is a useful tool for acquisition of both glucose metabolism and anatomic imaging data, as only a single device and one diagnostic session is required, thus opening a new field in clinical oncologic imaging. FDG-PET/CT has been successfully used for initial staging, restaging, assessment of early treatment response, evaluation of metastatic disease response, and prognostication of intestinal cancer as well as various malignant tumors. We reviewed the current status and role of FDG-PET/CT for management of patients with esophageal cancer, gastric cancer, and colorectal cancer, with focus on both its usefulness and limitations.
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Affiliation(s)
- Kazuhiro Kitajima
- Department of Radiology, Division of Nuclear Medicine and PET Center, Hyogo College of Medicine, Nishinomiya, Japan
| | - Masatoyo Nakajo
- Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Hayato Kaida
- Department of Radiology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Ryogo Minamimoto
- Department of Radiology, Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenji Hirata
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Hiroshi Doi
- Department of Radiation Oncology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Yoshiko Ueno
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keitaro Sofue
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yukihisa Tamaki
- Department of Radiation Oncology, Shimane University School of Medicine, Izumo, Japan
| | - Koichiro Yamakado
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan
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Abstract
Progressive technological advancements in imaging have significantly improved the preoperative sensitivity for the detection of very small foci of regionally- or hematogenously-metastatic colorectal cancer. Unfortunately, this information has not translated to continued linear gains in patient survival, and might even result in the false-positive upstaging of some cases: these are two conundrums in the imaging of colorectal cancer. Both conundrums might be resolved by the widespread use of real-time imaging guidance during operative procedures. This might open the way for the widespread use of fluorodeoxyglucose PET/CT for the initial staging of patients with colorectal cancer.
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Affiliation(s)
- Nathan C Hall
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Diagnostic Imaging, Nuclear Medicine, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, USA; Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus, OH 43210, USA.
| | - Alexander T Ruutiainen
- Diagnostic Radiology, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, USA
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Ellebæk SB, Fristrup CW, Mortensen MB. Intraoperative Ultrasound as a Screening Modality for the Detection of Liver Metastases during Resection of Primary Colorectal Cancer - A Systematic Review. Ultrasound Int Open 2017; 3:E60-E68. [PMID: 28597000 DOI: 10.1055/s-0043-100503] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 11/15/2016] [Accepted: 12/18/2016] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common cancer diseases worldwide. One in 4 patients with CRC will have a disseminated disease at the time of diagnosis and often in the form of synchronous liver metastases. Studies suggest that up to 30% of patients have non-recognized hepatic metastases during primary surgery for CRC. Intraoperative ultrasonography examination (IOUS) of the liver to detect liver metastases was considered the gold standard during open CRC surgery. Today laparoscopic surgery is the standard procedure, but laparoscopic ultrasound examination (LUS) is not performed routinely. Aim To perform a systematic review of the test performance of IOUS and LUS regarding the detection of synchronous liver metastases in patients undergoing surgery for primary CRC. Method The literature was systematically reviewed using the search engines: PubMed, Cochrane, Embase and Google. 21 studies were included in the review and the key words: intraoperative ultrasound, laparoscopic ultrasound, staging colon and rectum cancer. Results Intraoperative ultrasound showed a higher sensitivity, specificity, positive predictive value and overall accuracy for the detection liver metastases during surgery for primary CRC, compared to preoperative imaging modalities (ultrasound, computed tomography (CT) and contrast-enhanced computed tomography (CE-CT)). LUS showed a higher detection rate for liver metastases compared to CT, CE-CT and magnetic resonance imaging (MRI). Conclusion This systematic review found that both IOUS and LUS had a higher detection rate regarding liver metastases during primary CRC surgery, especially liver metastases<10 mm in diameter, when compared to US, CT, CE-CT and MRI.
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Rollvén E, Abraham-Nordling M, Holm T, Blomqvist L. Assessment and diagnostic accuracy of lymph node status to predict stage III colon cancer using computed tomography. Cancer Imaging 2017; 17:3. [PMID: 28103922 PMCID: PMC5248480 DOI: 10.1186/s40644-016-0104-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 12/24/2016] [Indexed: 12/23/2022] Open
Abstract
Background To study different imaging criteria for prediction of lymph node metastases (Stage III disease) in colon cancer using CT. Methods In a retrospective setting, 483 consecutive patients with histology proven colon cancer underwent elective primary resection during 2008–2011, a cohort of 119 patients were included. Contrast enhanced CT examinations, in portal-venous phase, were reviewed with assessment of the number of lymph nodes, their anatomical distribution, size, size ratio, internal heterogeneity, presence of irregular outer border and attenuation values. Sensitivity, specificity, PPV and NPV for each studied criteria for prediction of stage III disease was calculated. Results According to histopathology 80 patients were stage I-II and 39 were stage III. Of the studied CT-criteria for lymph node metastases per patient, internal heterogeneity in at least one lymph node resulted in the best performance with sensitivity, specificity, PPV and NPV of 79, 84, 70 and 89%, Odds ratio (OR) 20. Presence of irregular outer border resulted in a sensitivity, specificity, PPV and NPV of 59, 81, 61 and 82%, OR 6.2. If both internal heterogeneity and/or irregular outer border was used as a criterion this resulted in a sensitivity, specificity, PPV and NPV of 85, 75, 62 and 91%, OR 16.5. None of the size criteria used were predictive for stage III disease. Conclusions When performing preoperative CT in patients with colon cancer, the imaging criteria that allow best prediction of stage III disease on CT are either presence of at least one lymph node with internal heterogeneity or internal heterogeneity and/or irregular outer border. These criteria have to be validated in a prospective study.
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Affiliation(s)
- Erik Rollvén
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Department of Radiology, Karolinska University Hospital, Solna, SE - 171 76, Stockholm, Sweden.
| | - Mirna Abraham-Nordling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Torbjörn Holm
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Lennart Blomqvist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Department of Radiology, Karolinska University Hospital, Solna, SE - 171 76, Stockholm, Sweden
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Metabolic Tumor Volume and Total Lesion Glycolysis in PET/CT Correlate With the Pathological Findings of Colorectal Cancer and Allow Its Accurate Staging. Clin Nucl Med 2017; 41:761-5. [PMID: 27556789 DOI: 10.1097/rlu.0000000000001332] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION PET/CT plays an important role in cancer diagnosis. Recently, novel metabolic parameters in PET/CT such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have been reported to be diagnostic and prognostic biomarkers of various cancers. We evaluated the diagnostic value of these metabolic parameters in colorectal cancer (CRC). METHODS The study included 138 patients who underwent surgical resection of CRCs between August 2012 and March 2014. The MTVs and TLGs of tumors were measured using various SUV thresholds. The diagnostic abilities of the metabolic parameters were analyzed using ROC curves and classification and regression trees. RESULTS The AUCs of the MTVs and TLGs for predicting T stage (0.881-0.892) were significantly higher than the AUC of the SUVmax (0.824). In the M stage, the AUCs of MTVs and TLGs (0.688-0.723) were significantly higher than that of the SUVmax (0.606). Recursive partitioning applying classification and regression trees demonstrated that the optimal cutoff values of the most important variables for discriminating T, N, and M stages are MTV2.5 = 9.35 and 63.33 mL, TLG50% = 328.1, and TLG50% = 94.81, respectively. CONCLUSION Metabolic tumor volumes and TLGs in PET/CT are reliable diagnostic biomarkers. Using these parameters, more accurate preoperative diagnoses for CRC can be made.
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Diagnostic Accuracy of CT for Local Staging of Colon Cancer: A Systematic Review and Meta-Analysis. AJR Am J Roentgenol 2016; 207:984-995. [PMID: 27490941 DOI: 10.2214/ajr.15.15785] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The purpose of this article is to determine the accuracy of CT in the detection of tumor invasion beyond the bowel wall and nodal involvement of colon carcinomas. A literature search was performed to identify studies describing the accuracy of CT in the staging of colon carcinomas. Studies including rectal carcinomas that were inseparable from colon carcinomas were excluded. Publication bias was explored by using a Deeks funnel plot asymmetry test. A hierarchic summary ROC model was used to construct a summary ROC curve and to calculate summary estimates of sensitivity, specificity, and diagnostic odds ratios (ORs). CONCLUSION On the basis of a total of 13 studies, pooled sensitivity, specificity, and diagnostic ORs for detection of tumor invasion beyond the bowel wall (T3-T4) were 90% (95% CI, 83-95%), 69% (95% CI, 62-75%), and 20.6 (95% CI, 10.2-41.5), respectively. For detection of tumor invasion depth of 5 mm or greater (T3cd-T4), estimates from four studies were 77% (95% CI, 66-85%), 70% (95% CI, 53-83%), and 7.8 (95% CI, 4.2-14.2), respectively. For nodal involvement (N+), 16 studies were included with values of 71% (95% CI, 59-81%), 67% (95% CI, 46-83%), and 4.8 (95% CI, 2.5-9.4), respectively. Two studies using CT colonography were included with sensitivity and specificity of 97% (95% CI, 90-99%) and 81% (95% CI, 65-91%), respectively, for detecting T3-T4 tumors. CT has good sensitivity for the detection of T3-T4 tumors, and evidence suggests that CT colonography increases its accuracy. Discriminating between T1-T3ab and T3cd-T4 cancer is challenging, but data were limited. CT has a low accuracy in detecting nodal involvement.
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Ye Y, Liu T, Lu L, Wang G, Wang M, Li J, Han C, Wen J. Pre-operative TNM staging of primary colorectal cancer by (18)F-FDG PET-CT or PET: a meta-analysis including 2283 patients. Int J Clin Exp Med 2015; 8:21773-21785. [PMID: 26885142 PMCID: PMC4723987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/10/2015] [Indexed: 06/05/2023]
Abstract
The aim of the present study was to perform a meta-analysis to assess the diagnostic value of fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET-CT/PET in the pre-operative evaluation of TNM staging in patients with primary colorectal cancer (CRC). The Medline, Embase and Web of Knowledge were searched for studies assessing the diagnostic value of (18)F-FDG PET-CT/PET in the pre-operative evaluation of TNM staging in CRC patients. We pooled the sensitivity, specificity, positive and negative Likelihood ratio (LR+ and LR-) and Diagnostic Odds Ratio (DOR) and constructed summary receiver operating characteristic curves. A total of 28 studies including 2283 CRC patients were analyzed. The pre-operative tumor detecting rate of PET-CT was 95.35%, which was superior to CT (P < 0.05). The pooled sensitivity and specificity of pre-operative T staging by PET-CT/PET was 0.73 (95% CI: 0.65-0.81) and 0.99 (95% CI: 0.98-0.99), which the AUC and Q* were 0.96 and 0.91, respectively. Concerning pre-operative N staging, the pooled sensitivity and specificity of PET-CT/PET were 0.62 and 0.70, which the AUC and Q* were 0.76 and 0.70, respectively. As for M staging, the pooled sensitivity and specificity of PET-CT/PET were 0.91 (95% CI: 0.80-0.96) and 0.95 (95% CI: 0.91-0.98), which the AUC and Q* were 0.96 and 0.91, respectively. (18)F-FDG PET-CT/PET had good performance in the pre-operative tumor detecting rate, T staging and M staging in patients with primary CRC, which might alter the therapeutic strategy. However, the diagnostic value of (18)F-FDG PET-CT/PET in pre-operative N staging in CRC patients was not ideal.
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Affiliation(s)
- Yanwei Ye
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
- Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
| | - Tao Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
- Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
| | - Lisha Lu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
| | - Guojun Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
- Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
| | - Min Wang
- Department of Function, The Fifth Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
| | - Jingjing Li
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
| | - Chao Han
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
| | - Jianguo Wen
- Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China
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Comparison of (18)F-fluorodeoxyglucose PET/CT findings with vascular endothelial growth factors and receptors in colorectal cancer. Tumour Biol 2015; 37:3871-7. [PMID: 26476536 DOI: 10.1007/s13277-015-4218-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/12/2015] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to evaluate the association of (18)F-fluorodeoxyglucose (FDG)-PET/CT findings with the vascular endothelial growth factor (VEGF) family and its receptor (VEGFR) levels in metastatic and nonmetastatic colorectal cancer (CRC). Fluorine-18 FDG-PET/CT scans were performed for initial staging and restaging of patients with CRC. FDG-PET/CT findings of tumor (such as the presence of a primary tumor, the lymphatic or distance metastases, and the maximum standardized uptake value (SUVmax) of the primary tumor), serum VEGF A-C-D-E levels, and serum VEGF receptor 1-2-3 levels were analyzed. A total of 63 patients were included into the study (35 males, mean age 61.3 ± 11.9 years). Patients were divided into two groups, based on positive and negative PET/CT findings. Patients were also categorized according to the presence of metastasis. All evaluated parameters were significantly higher in the PET/CT-positive group than the PET/CT-negative group (p < 0.001). All those parameters were also positively correlated with each other. The highest correlation for SUVmax of primary tumor was found with VEGFR-3 (p < 0.001, r = 0.665). Patients with metastases had high levels of VEGF-D, VEGF-A, VEGF-C, VEGF-E, and VEGFR-3 than those without metastases. These parameters had better specificity and sensitivity values than the SUVmax of the primary tumor for detection of metastases. However, VEGF-D was the best indicator of metastasis in all of those parameters (VEGF-D vs SUVmax; sensitivity 100 vs 100 %; specificity 76 vs 76 %; AUC 0.903 vs 0.835; p < 0.001, respectively). Vascular endothelial growth factor family and its receptors were significantly higher in metastatic CRC patients. VEGF-D was the best indicator of metastasis than all VEGF family, VEGFR-3, and primary tumor SUVmax. VEGF family (A-C-D-E) and VEGFR-3 may help to determine the prognosis and management of CRC.
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Laurens ST, Oyen WJ. Impact of Fluorodeoxyglucose PET/Computed Tomography on the Management of Patients with Colorectal Cancer. PET Clin 2015; 10:345-60. [DOI: 10.1016/j.cpet.2015.03.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Kim YW, Kim IY. Preoperative staging with positron emission tomography in patients with colorectal cancer. Ann Coloproctol 2015; 30:247. [PMID: 25580408 PMCID: PMC4286768 DOI: 10.3393/ac.2014.30.6.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Young Wan Kim
- Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ik Yong Kim
- Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
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Kim HJ, Oh ST. The role of positron emission tomography/computed tomography in the initial staging of colon cancer. Ann Coloproctol 2014; 30:3-4. [PMID: 24639961 PMCID: PMC3953167 DOI: 10.3393/ac.2014.30.1.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Hyung Jin Kim
- Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Seong Taek Oh
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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