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Reliability of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Nodal Staging of Colorectal Cancer Patients

대한대장항문학회지 2014년 30권 6호 p.259 ~ 265
 ( Yi Hee-Jung ) - Ewha Womans University School of Medicine Department of Surgery

 ( Hong Kyung-Sook ) - Ewha Womans University School of Medicine Department of Surgery
 ( Moon Na-Ra ) - Ewha Womans University School of Medicine Department of Surgery
 ( Chung Soon-Sup ) - Ewha Womans University School of Medicine Department of Surgery
 ( Lee Ryung-Ah ) - Ewha Womans University School of Medicine Department of Surgery
 ( Kim Kwang-Ho ) - Ewha Womans University School of Medicine Department of Surgery

Abstract


Purpose: Lymph-node metastasis is considered as critical prognostic factor in colorectal cancer. A preoperative evaluation of lymph-node metastasis can also help to determine the range of distant lymph node dissection. However, the reliability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of lymph-node metastasis is not fully known.

Methods: The medical records of 433 patients diagnosed with colorectal cancer were reviewed retrospectively. FDG-PET/CT and CT were performed on all patients. Lymph nodes were classified into regional and distant lymph nodes according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th edition.

Results: The patients included 231 males (53.3%) and 202 females (46.7%), with a mean age of 64.7 ± 19.0 years. For regional lymph nodes, the sensitivity of FDG-PET/CT was lower than that of CT (57.1% vs. 73.5%, P < 0.001). For distant lymph nodes, the sensitivity of FDG-PET/CT was higher than that of CT (64.7% vs. 52.9%, P = 0.012). The sensitivity of FDG-PET/CT for regional lymph nodes was higher in patients with larger primary tumors. The positivity of lymph-node metastasis for FDG-PET/CT was affected by carcinoembryonic antigen levels, tumor location, and cancer stage for regional lymph nodes and by age and cancer stage for distant lymph nodes (P < 0.05).

Conclusion: The sensitivity of FDG-PET/CT for regional lymph-node metastasis was not superior to that of CT. However, FDG-PET/CT provides helpful information for determining surgical plan especially in high risk patients group.

키워드

Colorectal neoplasms; Positron emission tomography; Lymph node; Metastasis
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