The Role Of FDG PET-CT In Detection Of Recurrent Colorectal Cancer In National Cancer Institute, Putrajaya, Malaysia
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Date
2016
Authors
Wong, Teck Huat
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
This study aimed to determine the role of 18F-Fluorodeoxyglucose (FDG)
PET-CT in detection of recurrent colorectal cancer in our institution as well as to
correlate factors which may influence diagnostic performance of PET-CT. An Ethics
Board (from Universiti Sains Malaysia and Medical Research & Ethics Committee,
MREC) approved retrospective study was performed in National Cancer Institute,
Putrajaya from January to December 2014, recruiting all consecutive patients with
treated colorectal cancer and was suspected to have recurrence based on CEA levels
or CT imaging. PET-CT images were reviewed by a dedicated senior nuclear
medicine consultant. Histopathology or clinical and imaging follow up for at least six
months were used as reference standard to confirm the final diagnosis. 16 of 85
patients recruited were excluded from analysis due to unavailability of follow up data.
In the other 69 patients (M:F = 41:28), recurrence was diagnosed in 39.1%.
Sensitivity, specificity, positive predictive value, negative predictive value and
accuracy of PET-CT in detecting recurrent colorectal cancer in this study were 92.6%,
88.1%, 83.3%, 94.9% and 89.9% respectively. PET-CT had high diagnostic
performance to evaluate patients with elevated CEA levels and with suspicious CT
findings. It was more accurate than CT in detecting the true locations of recurrence
and could detect more sites of recurrence. Patients with rising CEA level but still
within normal limit and normal CT imaging had low risk of recurrence (0% in this
study) and were likely not indicated for PET-CT imaging. In conclusion, PET-CT is
sensitive and specific in detecting recurrent colorectal cancer.
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Keywords
The Role Of FDG PET-CT In Detection Of , Recurrent Colorectal Cancer