FDG-PET/CT is superior to enhanced CT in detecting recurrent subcentimeter lesions in the abdominopelvic cavity in colorectal cancer

Hai Jeon Yoon; Jong Jin Lee; Yu Kyeong Kim; Sang Eun Kim

doi:10.1007/s13139-011-0082-z

FDG-PET/CT is superior to enhanced CT in detecting recurrent subcentimeter lesions in the abdominopelvic cavity in colorectal cancer

Hai Jeon Yoon, Jong Jin Lee, Yu Kyeong Kim, Sang Eun Kim

Department of Nuclear Medicine

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Purpose This study aims to compare the performance of contrast-enhanced computed tomography (CeCT) and 18 Ffluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting small tumor implants and metastatic lymph nodes (LNs) in the abdominopelvic cavity in patients with colorectal cancer. Methods We enrolled 16 patients who were clinically suspected of experiencing a recurrence (6 male, 10 female; mean age 61±14 years). All subjects underwent CeCT and PET/CT, and the performance of these methods was compared with regard to detecting recurrences. The final diagnosis of a recurrence was made clinically. Results CeCT identified 38 lesions in 12 patients, all of which were detected by PET/CT. PET/CT found 27 additional lesions in 8 patients, comprising 9 seeding nodules (2 in the right upper quadrant of the abdomen and 7 in the pelvic cavity) and 18 LNs (2 celiac, 2 paraaortic, 2 hepatic hilar, 11 common iliac, 1 external iliac). Most additional lesions were located in the pelvic cavity (approximately 78% of seeding nodules and 67% of lymph nodes). The maximum standardized uptake value (SUVmax) of the additional seeding nodules that were detected solely by PET/CT was significantly higher compared with the CeCT- and PET/CT-confirmed nodules (5.5±4.2 vs. 2.9±2.5, p=0.03). The seeding nodules that were detected only by PET/CT were significantly smaller than the CeCT- and PET/CT-confirmed nodules (long axis: 1.0±0.3 cm vs. 2.0±1.1 cm, p=0.001; short axis: 0.8± 0.3 cm vs. 1.4±0.8 cm, p=0.004; mean of both axes: 0.9± 0.3 cm vs. 1.7±0.9 cm, p=0.001). Similarly, PET/CT-onlydetected LNs were significantly smaller than CeCT- and PET/CT-identified LNs (0.7±0.1 cm vs. 2.3±1.2 cm, p<0.0001). Conclusion PET/CT is superior to CeCT in detecting seeding nodules and metastatic LNs in patients with recurrent colorectal cancer. Specifically, PET/CT detects subcentimeter lesions in anatomically deformed pelvic cavities.

Original language	English
Pages (from-to)	132-138
Number of pages	7
Journal	Nuclear Medicine and Molecular Imaging
Volume	45
Issue number	2
DOIs	https://doi.org/10.1007/s13139-011-0082-z
State	Published - Jun 2011

Bibliographical note

Funding Information:
This research was supported by grant no. 11-2010-022 from the SNUBH Research Fund.

Keywords

Enhanced CT
PET/CT
Recurrent colorectal cancer
Subcentimeter

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10.1007/s13139-011-0082-z

Cite this

@article{3661254c9cd741ae97819a419d88e373,

title = "FDG-PET/CT is superior to enhanced CT in detecting recurrent subcentimeter lesions in the abdominopelvic cavity in colorectal cancer",

abstract = "Purpose This study aims to compare the performance of contrast-enhanced computed tomography (CeCT) and 18 Ffluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting small tumor implants and metastatic lymph nodes (LNs) in the abdominopelvic cavity in patients with colorectal cancer. Methods We enrolled 16 patients who were clinically suspected of experiencing a recurrence (6 male, 10 female; mean age 61±14 years). All subjects underwent CeCT and PET/CT, and the performance of these methods was compared with regard to detecting recurrences. The final diagnosis of a recurrence was made clinically. Results CeCT identified 38 lesions in 12 patients, all of which were detected by PET/CT. PET/CT found 27 additional lesions in 8 patients, comprising 9 seeding nodules (2 in the right upper quadrant of the abdomen and 7 in the pelvic cavity) and 18 LNs (2 celiac, 2 paraaortic, 2 hepatic hilar, 11 common iliac, 1 external iliac). Most additional lesions were located in the pelvic cavity (approximately 78% of seeding nodules and 67% of lymph nodes). The maximum standardized uptake value (SUVmax) of the additional seeding nodules that were detected solely by PET/CT was significantly higher compared with the CeCT- and PET/CT-confirmed nodules (5.5±4.2 vs. 2.9±2.5, p=0.03). The seeding nodules that were detected only by PET/CT were significantly smaller than the CeCT- and PET/CT-confirmed nodules (long axis: 1.0±0.3 cm vs. 2.0±1.1 cm, p=0.001; short axis: 0.8± 0.3 cm vs. 1.4±0.8 cm, p=0.004; mean of both axes: 0.9± 0.3 cm vs. 1.7±0.9 cm, p=0.001). Similarly, PET/CT-onlydetected LNs were significantly smaller than CeCT- and PET/CT-identified LNs (0.7±0.1 cm vs. 2.3±1.2 cm, p<0.0001). Conclusion PET/CT is superior to CeCT in detecting seeding nodules and metastatic LNs in patients with recurrent colorectal cancer. Specifically, PET/CT detects subcentimeter lesions in anatomically deformed pelvic cavities.",

keywords = "Enhanced CT, PET/CT, Recurrent colorectal cancer, Subcentimeter",

author = "Yoon, {Hai Jeon} and Lee, {Jong Jin} and Kim, {Yu Kyeong} and Kim, {Sang Eun}",

note = "Funding Information: This research was supported by grant no. 11-2010-022 from the SNUBH Research Fund. ",

year = "2011",

month = jun,

doi = "10.1007/s13139-011-0082-z",

language = "English",

volume = "45",

pages = "132--138",

journal = "Nuclear Medicine and Molecular Imaging",

issn = "1869-3474",

publisher = "Springer Verlag",

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T1 - FDG-PET/CT is superior to enhanced CT in detecting recurrent subcentimeter lesions in the abdominopelvic cavity in colorectal cancer

AU - Yoon, Hai Jeon

AU - Lee, Jong Jin

AU - Kim, Yu Kyeong

AU - Kim, Sang Eun

N1 - Funding Information: This research was supported by grant no. 11-2010-022 from the SNUBH Research Fund.

PY - 2011/6

Y1 - 2011/6

N2 - Purpose This study aims to compare the performance of contrast-enhanced computed tomography (CeCT) and 18 Ffluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting small tumor implants and metastatic lymph nodes (LNs) in the abdominopelvic cavity in patients with colorectal cancer. Methods We enrolled 16 patients who were clinically suspected of experiencing a recurrence (6 male, 10 female; mean age 61±14 years). All subjects underwent CeCT and PET/CT, and the performance of these methods was compared with regard to detecting recurrences. The final diagnosis of a recurrence was made clinically. Results CeCT identified 38 lesions in 12 patients, all of which were detected by PET/CT. PET/CT found 27 additional lesions in 8 patients, comprising 9 seeding nodules (2 in the right upper quadrant of the abdomen and 7 in the pelvic cavity) and 18 LNs (2 celiac, 2 paraaortic, 2 hepatic hilar, 11 common iliac, 1 external iliac). Most additional lesions were located in the pelvic cavity (approximately 78% of seeding nodules and 67% of lymph nodes). The maximum standardized uptake value (SUVmax) of the additional seeding nodules that were detected solely by PET/CT was significantly higher compared with the CeCT- and PET/CT-confirmed nodules (5.5±4.2 vs. 2.9±2.5, p=0.03). The seeding nodules that were detected only by PET/CT were significantly smaller than the CeCT- and PET/CT-confirmed nodules (long axis: 1.0±0.3 cm vs. 2.0±1.1 cm, p=0.001; short axis: 0.8± 0.3 cm vs. 1.4±0.8 cm, p=0.004; mean of both axes: 0.9± 0.3 cm vs. 1.7±0.9 cm, p=0.001). Similarly, PET/CT-onlydetected LNs were significantly smaller than CeCT- and PET/CT-identified LNs (0.7±0.1 cm vs. 2.3±1.2 cm, p<0.0001). Conclusion PET/CT is superior to CeCT in detecting seeding nodules and metastatic LNs in patients with recurrent colorectal cancer. Specifically, PET/CT detects subcentimeter lesions in anatomically deformed pelvic cavities.

AB - Purpose This study aims to compare the performance of contrast-enhanced computed tomography (CeCT) and 18 Ffluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting small tumor implants and metastatic lymph nodes (LNs) in the abdominopelvic cavity in patients with colorectal cancer. Methods We enrolled 16 patients who were clinically suspected of experiencing a recurrence (6 male, 10 female; mean age 61±14 years). All subjects underwent CeCT and PET/CT, and the performance of these methods was compared with regard to detecting recurrences. The final diagnosis of a recurrence was made clinically. Results CeCT identified 38 lesions in 12 patients, all of which were detected by PET/CT. PET/CT found 27 additional lesions in 8 patients, comprising 9 seeding nodules (2 in the right upper quadrant of the abdomen and 7 in the pelvic cavity) and 18 LNs (2 celiac, 2 paraaortic, 2 hepatic hilar, 11 common iliac, 1 external iliac). Most additional lesions were located in the pelvic cavity (approximately 78% of seeding nodules and 67% of lymph nodes). The maximum standardized uptake value (SUVmax) of the additional seeding nodules that were detected solely by PET/CT was significantly higher compared with the CeCT- and PET/CT-confirmed nodules (5.5±4.2 vs. 2.9±2.5, p=0.03). The seeding nodules that were detected only by PET/CT were significantly smaller than the CeCT- and PET/CT-confirmed nodules (long axis: 1.0±0.3 cm vs. 2.0±1.1 cm, p=0.001; short axis: 0.8± 0.3 cm vs. 1.4±0.8 cm, p=0.004; mean of both axes: 0.9± 0.3 cm vs. 1.7±0.9 cm, p=0.001). Similarly, PET/CT-onlydetected LNs were significantly smaller than CeCT- and PET/CT-identified LNs (0.7±0.1 cm vs. 2.3±1.2 cm, p<0.0001). Conclusion PET/CT is superior to CeCT in detecting seeding nodules and metastatic LNs in patients with recurrent colorectal cancer. Specifically, PET/CT detects subcentimeter lesions in anatomically deformed pelvic cavities.

KW - Enhanced CT

KW - PET/CT

KW - Recurrent colorectal cancer

KW - Subcentimeter

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FDG-PET/CT is superior to enhanced CT in detecting recurrent subcentimeter lesions in the abdominopelvic cavity in colorectal cancer

Abstract

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Keywords

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