Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
World Journal of Surgery
Published in: World Journal of Surgery 8/2012

01-08-2012

Diagnostic Value of FDG-PET/CT for Lymph Node Metastasis of Colorectal Cancer

Authors: Jae Young Kwak, Jae Seung Kim, Hye Jin Kim, Hyun Kwon Ha, Chang Sik Yu, Jin Cheon Kim

Published in: World Journal of Surgery | Issue 8/2012

Login to get access

Abstract

Background

Lymph node metastasis is an important prognostic factor in patients with colorectal cancer. We assessed the ability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) to diagnose lymph node metastases in colorectal cancer patients.

Methods

We retrospectively analyzed the records of 473 patients who underwent preoperative FDG-PET/CT, followed by curative surgery for colorectal cancer. Lymph node metastases were assessed as proximal or distal, depending on their anatomical location. We analyzed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of FDG-PET/CT and CT for detecting lymph node metastases.

Results

In detecting proximal lymph nodes, FDG-PET/CT had a sensitivity of 66 %, a specificity of 60 %, a PPV of 63 %, an NPV of 62 %, and an accuracy of 63 %; whereas CT had a sensitivity of 87 %, a specificity of 29 %, a PPV of 57 %, an NPV of 68 %, and an accuracy of 59 % (P = 0.245). FDG-PET/CT and CT also showed similar accuracy in detecting distal lymph nodes (87 vs. 88 %, P = 0.620).

Conclusion

Preoperative FDG-PET/CT and CT have comparable accuracy in detecting lymph node metastases of colorectal cancer.
Literature
1.
Cohen AM, Tremiterra S, Candela F et al (1991) Prognosis of node-positive colon cancer. Cancer 67:1859–1861PubMedCrossRef
2.
O’Dwyer ST, Haboubi NY, Johnson JS et al (2001) Detection of lymph node metastases in colorectal carcinoma. Colorectal Dis 3:288–294PubMedCrossRef
3.
Bipat S, Glas AS, Slors FJ et al (2004) Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging—a meta-analysis. Radiology 232:773–783PubMedCrossRef
4.
5.
Shin SS, Jeong YY, Min JJ et al (2008) Preoperative staging of colorectal cancer: CT versus integrated FDG PET/CT. Abdom Imaging 33:270–277PubMedCrossRef
6.
Park IJ, Kim HC, Yu CS et al (2006) Efficacy of PET/CT in the accurate evaluation of primary colorectal carcinoma. Eur J Surg Oncol 32:941–947PubMedCrossRef
7.
Erturk SM, Ichikawa T, Fujii H et al (2006) PET imaging for evaluation of metastatic colorectal cancer of the liver. Eur J Radiol 58:229–235PubMedCrossRef
8.
Abdel-Nabi H, Doerr RJ, Lamonica DM et al (1998) Staging of primary colorectal carcinomas with fluorine-18 fluorodeoxyglucose whole-body PET: correlation with histopathologic and CT findings. Radiology 206:755–760PubMed
9.
Kantorova I, Lipska L, Belohlavek O et al (2003) Routine [18]F-FDG PET preoperative staging of colorectal cancer: comparison with conventional staging and its impact on treatment decision making. J Nucl Med 44:1784–1788PubMed
10.
Bar-Shalom R, Yefremov N, Guralnik L et al (2003) Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med 44:1200–1209PubMed
11.
12.
Cohade C, Osman M, Leal J et al (2003) Direct comparison of [18]F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med 44:1797–1803PubMed
13.
Selzner M, Hany TF, Wildbrett P et al (2004) Does the novel PET/CT imaging modality impact on the treatment of patients with metastatic colorectal cancer of the liver? Ann Surg 240:1027–1034 discussion 1035–1026PubMedCrossRef
14.
Japanese Society for Cancer of the Colon and Rectum (2006) Japanese classification of colorectal carcinoma. Kanehara, Tokyo
15.
Antoch G, Saoudi N, Kuehl H et al (2004) Accuracy of whole-body dual-modality fluorine-18-2-fluoro-2-deoxy-d-glucose positron emission tomography and computed tomography (FDG-PET/CT) for tumor staging in solid tumors: comparison with CT and PET. J Clin Oncol 22:4357–4368PubMedCrossRef
16.
Niekel MC, Bipat S, Stoker J (2010) Diagnostic imaging of colorectal liver metastases with CT, MR imaging, FDG PET, and/or FDG PET/CT: a meta-analysis of prospective studies including patients who have not previously undergone treatment. Radiology 257:674–684PubMedCrossRef
17.
Avril N (2004) GLUT1 expression in tissue and [18]F-FDG uptake. J Nucl Med 45:930–932PubMed
18.
Inoue K, Sato T, Kitamura H et al (2008) Improvement of the diagnostic accuracy of lymph node metastases of colorectal cancer in 18F-FDG-PET/CT by optimizing the iteration number for the image reconstruction. Ann Nucl Med 22:465–473PubMedCrossRef
19.
Dukes CE, Bussey HJ (1958) The spread of rectal cancer and its effect on prognosis. Br J Cancer 12:309–320PubMedCrossRef
20.
Hermanek P, Altendorf A (1981) Classification of colorectal carcinomas with regional lymphatic metastases. Pathol Res Pract 173:1–11PubMedCrossRef
21.
Kim JS, Sohn DK, Park JW et al (2011) Prognostic significance of distribution of lymph node metastasis in advanced mid or low rectal cancer. J Surg Oncol 104:486–492PubMedCrossRef
22.
Sugihara K, Kobayashi H, Kato T et al (2006) Indication and benefit of pelvic sidewall dissection for rectal cancer. Dis Colon Rectum 49:1663–1672PubMedCrossRef
23.
Di Matteo G, Mascagni D, Tarroni D (1991) Radical surgery for rectal cancer. J Surg Oncol Suppl 2:32–35PubMedCrossRef
24.
Leggeri A, Roseano M, Balani A et al (1994) Lumboaortic and iliac lymphadenectomy: what is the role today? Dis Colon Rectum 37:S54–S61PubMedCrossRef
25.
Hojo K, Sawada T, Moriya Y (1989) An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadenectomy. Dis Colon Rectum 32:128–133PubMedCrossRef
26.
27.
Fong Y, Saldinger PF, Akhurst T et al (1999) Utility of 18F-FDG positron emission tomography scanning on selection of patients for resection of hepatic colorectal metastases. Am J Surg 178:282–287PubMedCrossRef
28.
Desai DC, Zervos EE, Arnold MW et al (2003) Positron emission tomography affects surgical management in recurrent colorectal cancer patients. Ann Surg Oncol 10:59–64PubMedCrossRef
29.
Truant S, Huglo D, Hebbar M et al (2005) Prospective evaluation of the impact of [18F]fluoro-2-deoxy-d-glucose positron emission tomography of resectable colorectal liver metastases. Br J Surg 92:362–369PubMedCrossRef
30.
Lardinois D, Weder W, Hany TF et al (2003) Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 348:2500–2507PubMedCrossRef
31.
Flamen P, Stroobants S, Van Cutsem E et al (1999) Additional value of whole-body positron emission tomography with fluorine-18-2-fluoro-2-deoxy-d-glucose in recurrent colorectal cancer. J Clin Oncol 17:894–901PubMed
32.
Chowdhury FU, Shah N, Scarsbrook AF et al (2010) [18F]FDG PET/CT imaging of colorectal cancer: a pictorial review. Postgrad Med J 86:174–182PubMedCrossRef
33.
Wong JH, Severino R, Honnebier MB et al (1999) Number of nodes examined and staging accuracy in colorectal carcinoma. J Clin Oncol 17:2896–2900PubMed
34.
Goldstein NS (2002) Lymph node recoveries from 2427 pT3 colorectal resection specimens spanning 45 years: recommendations for a minimum number of recovered lymph nodes based on predictive probabilities. Am J Surg Pathol 26:179–189PubMedCrossRef
35.
Le Voyer TE, Sigurdson ER, Hanlon AL et al (2003) Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol 21:2912–2919PubMedCrossRef
36.
Pusztaszeri M, Matter M, Kuonen A et al (2009) Nodal staging in colorectal cancer: should distant lymph nodes be recovered in surgical specimens? Hum Pathol 40:552–557PubMedCrossRef
37.
Smith NJ, Bees N, Barbachano Y et al (2007) Preoperative computed tomography staging of nonmetastatic colon cancer predicts outcome: implications for clinical trials. Br J Cancer 96:1030–1036PubMedCrossRef
38.
McDaniel KP, Charnsangavej C, DuBrow RA et al (1993) Pathways of nodal metastasis in carcinomas of the cecum, ascending colon, and transverse colon: CT demonstration. AJR Am J Roentgenol 161:61–64PubMed
39.
Granfield CA, Charnsangavej C, Dubrow RA et al (1992) Regional lymph node metastases in carcinoma of the left side of the colon and rectum: CT demonstration. AJR Am J Roentgenol 159:757–761PubMed
40.
Pomerri F, Maretto I, Pucciarelli S et al (2009) Prediction of rectal lymph node metastasis by pelvic computed tomography measurement. Eur J Surg Oncol 35:168–173PubMedCrossRef
41.
42.
Adams MC, Turkington TG, Wilson JM et al (2010) A systematic review of the factors affecting accuracy of SUV measurements. AJR Am J Roentgenol 195:310–320PubMedCrossRef
Metadata
Title
Diagnostic Value of FDG-PET/CT for Lymph Node Metastasis of Colorectal Cancer
Authors
Jae Young Kwak
Jae Seung Kim
Hye Jin Kim
Hyun Kwon Ha
Chang Sik Yu
Jin Cheon Kim
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 8/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-012-1575-3

Other articles of this Issue 8/2012

World Journal of Surgery 8/2012 Go to the issue

OriginalPaper

Success and Failure for Children Born with Facial Clefts in Africa: A 15-Year Follow-up

OriginalPaper

A Preliminary Comparison Study of Two Noncrosslinked Biologic Meshes Used in Complex Ventral Hernia Repairs

OriginalPaper

Evidence-Based Surgery: Barriers, Solutions, and the Role of Evidence Synthesis

OriginalPaper

Preoperative Pancreas CT/MRI Characteristics Predict Fistula Rate after Pancreaticoduodenectomy

OriginalPaper

Patients with Multiple Hepatocellular Carcinomas Within the UCSF Criteria Have Outcomes After Curative Resection Similar to Patients Within the BCLC Early-Stage Criteria

OriginalPaper

Diagnostic Role of Procalcitonin in Patients with Suspected Appendicitis