Direct comparison of 18F-FDG PET and PET/CT in patients with colorectal carcinoma

Christian Cohade, Medhat Osman, Jeffrey Pettit Leal, Richard L. Wahl

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to compare 18F-FDG PET and PET/CT in a population of patients with colorectal cancer. Methods: PET and PET/CT images from 45 patients (17 women, 28 men; mean age ± SD, 60.8 ± 11.1 y) with known colorectal cancer referred for PET from June to November 2001 were retrospectively reviewed. Images were acquired with a PET/CT scanner, and 68Ge attenuation correction was applied. PET images and fused 68Ge attenuation-corrected PET and CT images were independently and separately interpreted by a moderately experienced reader unaware of the clinical information. Certainty of lesion characterization was scored on a 5-point scale (0 = definitely benign, 1 = probably benign, 2 = equivocal, 3 = probably malignant, 4 = definitely malignant). Lesion location was scored on a 3-point scale (0 = uncertain, 1 = probable, 2 = definite). The presence or absence of tumor was subsequently assessed using all available clinical, pathologic, and follow-up information. Analysis was provided for lesions detected by both PET and PET/CT. Results: The frequency of equivocal and probable lesion characterization was reduced by 50% (50 to 25) with PET/CT, in comparison with PET. The frequency of definite lesion characterization was increased by 30% (84 to 109) with PET/CT. The number of definite locations was increased by 25% (92 to 115) with PET/CT. Overall correct staging increased from 78% to 89% with PET/CT on a patient-by-patient analysis. Conclusion: PET/CT imaging increases the accuracy and certainty of locating lesions in colorectal cancer. More definitely normal and definitely abnormal lesions (and fewer probable and equivocal lesions) were identified with PET/CT than with PET alone. Staging and restaging accuracy improved from 78% to 89%.

Original languageEnglish (US)
Pages (from-to)1797-1803
Number of pages7
JournalJournal of Nuclear Medicine
Volume44
Issue number11
StatePublished - Nov 2003

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Fluorodeoxyglucose F18
Colorectal Neoplasms
Population
Neoplasms

Keywords

  • F-FDG
  • Colorectal carcinoma
  • CT
  • PET
  • PET/CT

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Direct comparison of 18F-FDG PET and PET/CT in patients with colorectal carcinoma. / Cohade, Christian; Osman, Medhat; Leal, Jeffrey Pettit; Wahl, Richard L.

In: Journal of Nuclear Medicine, Vol. 44, No. 11, 11.2003, p. 1797-1803.

Research output: Contribution to journalArticle

Cohade, Christian ; Osman, Medhat ; Leal, Jeffrey Pettit ; Wahl, Richard L. / Direct comparison of 18F-FDG PET and PET/CT in patients with colorectal carcinoma. In: Journal of Nuclear Medicine. 2003 ; Vol. 44, No. 11. pp. 1797-1803.
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abstract = "The purpose of this study was to compare 18F-FDG PET and PET/CT in a population of patients with colorectal cancer. Methods: PET and PET/CT images from 45 patients (17 women, 28 men; mean age ± SD, 60.8 ± 11.1 y) with known colorectal cancer referred for PET from June to November 2001 were retrospectively reviewed. Images were acquired with a PET/CT scanner, and 68Ge attenuation correction was applied. PET images and fused 68Ge attenuation-corrected PET and CT images were independently and separately interpreted by a moderately experienced reader unaware of the clinical information. Certainty of lesion characterization was scored on a 5-point scale (0 = definitely benign, 1 = probably benign, 2 = equivocal, 3 = probably malignant, 4 = definitely malignant). Lesion location was scored on a 3-point scale (0 = uncertain, 1 = probable, 2 = definite). The presence or absence of tumor was subsequently assessed using all available clinical, pathologic, and follow-up information. Analysis was provided for lesions detected by both PET and PET/CT. Results: The frequency of equivocal and probable lesion characterization was reduced by 50{\%} (50 to 25) with PET/CT, in comparison with PET. The frequency of definite lesion characterization was increased by 30{\%} (84 to 109) with PET/CT. The number of definite locations was increased by 25{\%} (92 to 115) with PET/CT. Overall correct staging increased from 78{\%} to 89{\%} with PET/CT on a patient-by-patient analysis. Conclusion: PET/CT imaging increases the accuracy and certainty of locating lesions in colorectal cancer. More definitely normal and definitely abnormal lesions (and fewer probable and equivocal lesions) were identified with PET/CT than with PET alone. Staging and restaging accuracy improved from 78{\%} to 89{\%}.",
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AB - The purpose of this study was to compare 18F-FDG PET and PET/CT in a population of patients with colorectal cancer. Methods: PET and PET/CT images from 45 patients (17 women, 28 men; mean age ± SD, 60.8 ± 11.1 y) with known colorectal cancer referred for PET from June to November 2001 were retrospectively reviewed. Images were acquired with a PET/CT scanner, and 68Ge attenuation correction was applied. PET images and fused 68Ge attenuation-corrected PET and CT images were independently and separately interpreted by a moderately experienced reader unaware of the clinical information. Certainty of lesion characterization was scored on a 5-point scale (0 = definitely benign, 1 = probably benign, 2 = equivocal, 3 = probably malignant, 4 = definitely malignant). Lesion location was scored on a 3-point scale (0 = uncertain, 1 = probable, 2 = definite). The presence or absence of tumor was subsequently assessed using all available clinical, pathologic, and follow-up information. Analysis was provided for lesions detected by both PET and PET/CT. Results: The frequency of equivocal and probable lesion characterization was reduced by 50% (50 to 25) with PET/CT, in comparison with PET. The frequency of definite lesion characterization was increased by 30% (84 to 109) with PET/CT. The number of definite locations was increased by 25% (92 to 115) with PET/CT. Overall correct staging increased from 78% to 89% with PET/CT on a patient-by-patient analysis. Conclusion: PET/CT imaging increases the accuracy and certainty of locating lesions in colorectal cancer. More definitely normal and definitely abnormal lesions (and fewer probable and equivocal lesions) were identified with PET/CT than with PET alone. Staging and restaging accuracy improved from 78% to 89%.

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