Research Article
BibTex RIS Cite

Kolorektal kanserlerin yeniden evrelemesinde F-18 FDG PET/BT’nin önemi

Year 2022, , 16 - 21, 24.03.2022
https://doi.org/10.47582/jompac.1053300

Abstract

Giriş: Bu çalışmada, kolorektal kanserli hastalarda, uygulanan cerrahi, kemoterapi, radyoterapi sonrası takip döneminde hastalığın nüksünü düşündürür belirti ve bulgu varlığında nüksü doğrulamak ve hastalığın yayılım bölgelerini saptamak için yapılan yeniden evrelemede F-18 FDG PET/BT’nin öneminin saptanması amaçlanmıştır. Bunun için PET/BT görüntüleri, BT görüntüleri ile karşılaştırılmış ve serum CEA düzeyi ile görüntüleme yöntemlerinin uyumu incelenmiştir. Ayrıca, yeniden evrelemede patolojik bulgu saptanan hastalarda uygulanan tedavi sonrası tedaviye cevabın belirlenmesinde PET/BT’nin rolü de araştırılmıştır.
Gereç ve Yöntem: Retrospektif olarak yapılan bu çalışmaya, 102 hasta dahil edilmiştir. Tüm hastalara yeniden evrelendirme amacıyla F-18 FDG ile PET/BT görüntülemesi yapılmış olup PET/BT sonuçları, eş zamanlı olarak yapılan BT, serum CEA düzeyi ve klinik, eğer varsa histopatolojik incelemenin sonuçları ile karşılaştırılmıştır.
Bulgular: Çalışmada, nüks şüphesi olan kolorektal kanserli olgularda, PET/BT’nin patoloji saptama oranı %98, BT’nin ise %64,7 olarak hesaplanmıştır. BT’de patoloji izlenmeyen 34 hastada PET/BT ile patolojik lezyonların görüntülenebildiği, serum CEA düzeyi normal olan 70 hastanın 68’inde PET/BT ile, 45’inde ise BT ile patolojik lezyonun lokalize edildiği görülmüştür. Yapılan değerlendirmede, nüks hastalığın saptanmasında PET/BT’nin BT’den daha başarılı olduğu sonucuna ulaşılmıştır.
Sonuç: Bu bilgiler ışığında, takip döneminde nüks şüphesi olan kolorektal kanserli olguların yeniden evrelemesinde ve sonrasında yapılan tedavinin etkinliğinin değerlendirilmesinde F-18 PET/BT’nin yararlı olduğu sonucuna ulaşılmıştır.

References

  • Büyükdoğan M. Kolorektal kanserde genetik ve etiyolojik faktörler. Selçuk Tıp Derg 2009; 25: 171-80.
  • Czernin J, Allen-Auerbach M, Schelbert HR. Improvements in cancer staging with PET/CT: literature-based evidence as of September 2006. J Nucl Med 2007; 48: 78-8.
  • Wiering B, Krabbe PF, Jager GJ, Oyen WJ, Ruers TJ The impact of fluor-18-dexyglucose-positron emission tomography in the management of colorectal liver metastases: a systematic review and metaanalysis. Cancer 2005; 104: 2658-70.
  • Potter KC, Husband JE, Houghton SL, Thomas K, Brown G. Diagnostic accuracy of serial CT/magnetic resonance imaging review vs. positron emission tomography/CT in colorectal cancer patients with suspected and known recurrence. Dis Colon Rectum 2009; 52: 253-9.
  • 5- Graham RA, Wang S, Catalano PJ, Haller DG. Postsurgical surveillance of colon cancer: preliminay cost analysis of physician examination, carcinoembryonic antigen testing, chest X-ray, and colonoscopy. Ann Surg 1998; 228: 59-63.
  • Figueredo A, Rumble RB, Maroun J, et al. Follow-up of patients with curatively resected colorectal cancer: a practice guideline. BMC Cancer 2003; 3: 26-39.
  • Zealley IA, Skehan SJ, Rawlinson J, et al. Selection of patients for resection of hepatic metastases: Improved detection of extrahepatic disease with FDG PET. Radiographics 2001; 21: 55-69.
  • Kostakoğlu L, Goldsmith SJ. 18F-FDG PET evaluation of response to therapy for lymphoma and for breast, lung, and colorectal carcinoma. J Nucl Med 2003; 44: 224-39.
  • Lechner P, Lind P, Goldenberg DM. Can postoperative surveillance with serial CEA immunoscintigraphy detect resectable rectal cancer recurrence and potentially improve tumor-free survival? J Am Coll Surg. 2000; 191: 511-8.
  • Esteves FP, Schuster DM, Haklar RK. Gastrointestinal tract malignancies and positron emission tomography: An overview. Semin Nucl Med 2006; 36: 169-181.
  • Sarikaya I, Bloomston M, Povoski SP, et al. FDG-PET scan in patients with clinically and/or radiologically suspicious colorectal cancer recurrence but normal CEA. World J Surg Oncol 2007; 5: 64-72.
  • Dirisamer A, Halpern, BS, Flöry D, et al. Performance of integrated FDG-PET/contrast –enhanced CT in the staging and restaging of colorectal cancer: Comparison with PET and enhanced CT. Eur J Radiol 2010; 73: 324-8.
  • Soyka JD, Veit-Haibach P, Strobel K, et al. Staging pathways in recurrent colorectal carcinoma: is contrast-enhanced F-18-FDG PET/CT the diagnostic tool of choice? J Nucl Med 2008; 49: 354-61.
  • Skandalakis William C. Wood, John E. Surgical anatomy and tecnique. Atlanta (GA): Skandalakis Quality Medical Publishing; 1995.
  • Kalaycı G. Kolon Kanserleri, Genel Cerrahi, Istanbul: Nobel Tip Kitabevi; 2002.
  • Farrokh D. Utility of FDG-PET for investigating unexplained plasma CEA elevation in patients with colorectal cancer. Ann Surg 1998; 227: 319.
  • Schlag P, Lehner B, Strauss LG, Georgi P. Herfarth C. Scar or recurrent rectal cancer Arch Surg 1989; 124:197-200.
  • Ogunbiyi OA, Flanagan FL, Dehdashti F, et al. Detection recurrent and metastatic colorectal cancer: comparison of PET and CT. Ann Surg Oncol 1997; 4: 613-20.
  • Shamim SA, Kumar R, Halanaik D, et al. Role of FDG-PET/CT in detection of recurrent disease in colorectal cancer. Nuclear Medicine Communications 2010, 31: 590-6.
  • Jingu K, Ariga H, Kaneta T, et al. Focal dose escalation using FDG-PET guided intensity-modulated radiation therapy boost for postoperative local recurrent rectal cancer: a planning study with comparison of DVH and NTCP BMC Cancer 2010; 10: 127.
  • Brethauer SA, Magrino TJ, Riffenburgh RH, Johnstone PA. Management of recurrent colorectal carcinoma. Colorectal Dis 2002; 4: 246-53.
  • Sharma R, Aboagye E. Development of radiotracers for oncology--the interface with pharmacology, Br J Pharmacol. 2011; 163: 1565-85.
  • Huebner RH, Park KC, Shepherd JE, et al. A meta-analysis of the literature for whole-body FDG PET detection of recurrent colorectal cancer. J Nucl Med 2000; 41: 1177-89.
  • Kanser bildirimlerinin değerlendirilmesi 1993-1994. Ankara: TC Sağlık Bakanlığı Kanser Savaş Daire Başkanlığı, Yayın No: 582; 1997.
  • Jacek R. Colorectal cancer management in Poland: Current improvements and future challenges. Eur J Health Econ 2010; 10 (Suppl 1): 57- 63.
  • Willkomm P, Bender H, Bangard M, Decker P, Grünwald F, Biersack HJ. FDG PET and immunoscintigraphy with 99mTc-labeled antibody fragments for detection of the recurrence of colorectal carcinoma. J Nuclear Med 2000; 41: 1657-63.
  • Niekel MC, Bipat S, Stoker J. 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 2010; 257: 674-84.
  • Abd Elhalim RM, Khalifa DN, Alfawal, FM, Salem AF. Role of PET/CT in evaluation of postoperative colorectal cancer. Zagazig University Med J 2001;27: 712-23.
  • Selzner M, Hany TF, Wildbrett P, McCormack L, Kadry Z, Clavien PA.  Does the novel PET/CT imaging modality impact on the treatment of patients with metastatic colorectal cancer of the liver? Ann Surg 2004; 240: 1027-36.
  • Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Tangen C. An evaluation of the carcinoembryonic antigen (CEA) test for monitoring patients with resected colon cancer. JAMA 1993; 270: 943-7.
  • McCall JL, Black RB, Rich CA, et al. The value of serum carcinoembryonic antigen in predicting recurrent disease following curative resection of colorectal cancer. Dis Colon Rectum 1994; 37: 875-81.
  • Kalff V, Hicks RJ, Ware RE, et al. The clinical impact of (18)F-FDG PET in patients with suspected or confirmed recurrence. J Nuclear Med 2002; 43: 492-9.

The Impact Of F-18 FDG PET/CT In the restaging of colorectal cancer in patients with suspected recurrence

Year 2022, , 16 - 21, 24.03.2022
https://doi.org/10.47582/jompac.1053300

Abstract

Aim: The aim of the present study is to investigate the impact of F-18 FDG PET/CT in the restaging of colorectal cancer in patients with suspected recurrence. Thus, PET/CT findings were compared with that of CT. In addition, the correlation between serum CEA levels and PET/CT and CT findings was investigated. Furthermore, the role of PET/CT in treatment response among patients who were treated after restaging was assessed.
Material and Method: In this retrospective study, a total of 102 patients operated for colorectal cancer (63 female, 39 male, mean age 65.81±4.63 years) were investigated. F-18 FDG PET/CT scans were acquired in all patients. The findings of PET/CT were compared with that of concurrent CT, and also with CEA levels.
Results: In the study, the success rates of PET/CT and CT in detecting pathologic lesions in colorectal cancer cases with suspected recurrence were 98% and 64.7%, respectively. In 34 cases, pathologic lesions were detected with PET/CT, while CT showed no recurrence. The lesions of 68 cases out of 70 with high CEA levels were localized by means of PET/CT, whereas pathology was observed by CT in only 45 cases. Thus, PET/CT was considered more successful than CT in detecting recurrence. In the liver where lesion was localized the most, the sensitivity and specificity of PET/CT were 88% and 92%, respectively, while the sensitivity and specificity of CT were 80% and 76%, respectively.
Conclusion: In the light of findings, our study suggested PET/CT as a valuable imaging tool for restaging and treatment response assessment in colorectal cancer cases with suspected recurrence.

References

  • Büyükdoğan M. Kolorektal kanserde genetik ve etiyolojik faktörler. Selçuk Tıp Derg 2009; 25: 171-80.
  • Czernin J, Allen-Auerbach M, Schelbert HR. Improvements in cancer staging with PET/CT: literature-based evidence as of September 2006. J Nucl Med 2007; 48: 78-8.
  • Wiering B, Krabbe PF, Jager GJ, Oyen WJ, Ruers TJ The impact of fluor-18-dexyglucose-positron emission tomography in the management of colorectal liver metastases: a systematic review and metaanalysis. Cancer 2005; 104: 2658-70.
  • Potter KC, Husband JE, Houghton SL, Thomas K, Brown G. Diagnostic accuracy of serial CT/magnetic resonance imaging review vs. positron emission tomography/CT in colorectal cancer patients with suspected and known recurrence. Dis Colon Rectum 2009; 52: 253-9.
  • 5- Graham RA, Wang S, Catalano PJ, Haller DG. Postsurgical surveillance of colon cancer: preliminay cost analysis of physician examination, carcinoembryonic antigen testing, chest X-ray, and colonoscopy. Ann Surg 1998; 228: 59-63.
  • Figueredo A, Rumble RB, Maroun J, et al. Follow-up of patients with curatively resected colorectal cancer: a practice guideline. BMC Cancer 2003; 3: 26-39.
  • Zealley IA, Skehan SJ, Rawlinson J, et al. Selection of patients for resection of hepatic metastases: Improved detection of extrahepatic disease with FDG PET. Radiographics 2001; 21: 55-69.
  • Kostakoğlu L, Goldsmith SJ. 18F-FDG PET evaluation of response to therapy for lymphoma and for breast, lung, and colorectal carcinoma. J Nucl Med 2003; 44: 224-39.
  • Lechner P, Lind P, Goldenberg DM. Can postoperative surveillance with serial CEA immunoscintigraphy detect resectable rectal cancer recurrence and potentially improve tumor-free survival? J Am Coll Surg. 2000; 191: 511-8.
  • Esteves FP, Schuster DM, Haklar RK. Gastrointestinal tract malignancies and positron emission tomography: An overview. Semin Nucl Med 2006; 36: 169-181.
  • Sarikaya I, Bloomston M, Povoski SP, et al. FDG-PET scan in patients with clinically and/or radiologically suspicious colorectal cancer recurrence but normal CEA. World J Surg Oncol 2007; 5: 64-72.
  • Dirisamer A, Halpern, BS, Flöry D, et al. Performance of integrated FDG-PET/contrast –enhanced CT in the staging and restaging of colorectal cancer: Comparison with PET and enhanced CT. Eur J Radiol 2010; 73: 324-8.
  • Soyka JD, Veit-Haibach P, Strobel K, et al. Staging pathways in recurrent colorectal carcinoma: is contrast-enhanced F-18-FDG PET/CT the diagnostic tool of choice? J Nucl Med 2008; 49: 354-61.
  • Skandalakis William C. Wood, John E. Surgical anatomy and tecnique. Atlanta (GA): Skandalakis Quality Medical Publishing; 1995.
  • Kalaycı G. Kolon Kanserleri, Genel Cerrahi, Istanbul: Nobel Tip Kitabevi; 2002.
  • Farrokh D. Utility of FDG-PET for investigating unexplained plasma CEA elevation in patients with colorectal cancer. Ann Surg 1998; 227: 319.
  • Schlag P, Lehner B, Strauss LG, Georgi P. Herfarth C. Scar or recurrent rectal cancer Arch Surg 1989; 124:197-200.
  • Ogunbiyi OA, Flanagan FL, Dehdashti F, et al. Detection recurrent and metastatic colorectal cancer: comparison of PET and CT. Ann Surg Oncol 1997; 4: 613-20.
  • Shamim SA, Kumar R, Halanaik D, et al. Role of FDG-PET/CT in detection of recurrent disease in colorectal cancer. Nuclear Medicine Communications 2010, 31: 590-6.
  • Jingu K, Ariga H, Kaneta T, et al. Focal dose escalation using FDG-PET guided intensity-modulated radiation therapy boost for postoperative local recurrent rectal cancer: a planning study with comparison of DVH and NTCP BMC Cancer 2010; 10: 127.
  • Brethauer SA, Magrino TJ, Riffenburgh RH, Johnstone PA. Management of recurrent colorectal carcinoma. Colorectal Dis 2002; 4: 246-53.
  • Sharma R, Aboagye E. Development of radiotracers for oncology--the interface with pharmacology, Br J Pharmacol. 2011; 163: 1565-85.
  • Huebner RH, Park KC, Shepherd JE, et al. A meta-analysis of the literature for whole-body FDG PET detection of recurrent colorectal cancer. J Nucl Med 2000; 41: 1177-89.
  • Kanser bildirimlerinin değerlendirilmesi 1993-1994. Ankara: TC Sağlık Bakanlığı Kanser Savaş Daire Başkanlığı, Yayın No: 582; 1997.
  • Jacek R. Colorectal cancer management in Poland: Current improvements and future challenges. Eur J Health Econ 2010; 10 (Suppl 1): 57- 63.
  • Willkomm P, Bender H, Bangard M, Decker P, Grünwald F, Biersack HJ. FDG PET and immunoscintigraphy with 99mTc-labeled antibody fragments for detection of the recurrence of colorectal carcinoma. J Nuclear Med 2000; 41: 1657-63.
  • Niekel MC, Bipat S, Stoker J. 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 2010; 257: 674-84.
  • Abd Elhalim RM, Khalifa DN, Alfawal, FM, Salem AF. Role of PET/CT in evaluation of postoperative colorectal cancer. Zagazig University Med J 2001;27: 712-23.
  • Selzner M, Hany TF, Wildbrett P, McCormack L, Kadry Z, Clavien PA.  Does the novel PET/CT imaging modality impact on the treatment of patients with metastatic colorectal cancer of the liver? Ann Surg 2004; 240: 1027-36.
  • Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Tangen C. An evaluation of the carcinoembryonic antigen (CEA) test for monitoring patients with resected colon cancer. JAMA 1993; 270: 943-7.
  • McCall JL, Black RB, Rich CA, et al. The value of serum carcinoembryonic antigen in predicting recurrent disease following curative resection of colorectal cancer. Dis Colon Rectum 1994; 37: 875-81.
  • Kalff V, Hicks RJ, Ware RE, et al. The clinical impact of (18)F-FDG PET in patients with suspected or confirmed recurrence. J Nuclear Med 2002; 43: 492-9.
There are 32 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Alev Çınar

Esra Arzu Gencoglu 0000-0003-4631-1683

Publication Date March 24, 2022
Published in Issue Year 2022

Cite

AMA Çınar A, Gencoglu EA. The Impact Of F-18 FDG PET/CT In the restaging of colorectal cancer in patients with suspected recurrence. J Med Palliat Care / JOMPAC / Jompac. March 2022;3(1):16-21. doi:10.47582/jompac.1053300

images?q=tbn:ANd9GcRrI_RWgGRe7JRpz3PAnkt2YEFD2l6WEmgHMzuM2w9b&s

f9ab67f.png     

7yziemq.png




COPE.jpg

icmje_1_orig.png

cc.logo.large.png

ncbi.png

ORCID_logo.png

images?q=tbn:ANd9GcQk2AsOdjP67NBkYAqd8FHwCmh0_3dkMrXh3mFtfPKXwIai7h0lIds8QYM9YjKMhZw8iP0&usqp=CAU

logo_world_of_journals_no_margin.png1280px-WorldCat_logo.svg.png                             images?q=tbn:ANd9GcRrI_RWgGRe7JRpz3PAnkt2YEFD2l6WEmgHMzuM2w9b&s


Dergimiz; TR-Dizin ULAKBİM, ICI World of  Journal's, Index Copernicus, Directory of Research Journals Indexing (DRJI), General Impact Factor, Google Scholar, Researchgate, WorldCat (OCLC), CrossRef (DOI), ROAD, ASOS İndeks, Türk Medline İndeks, Eurasian Scientific Journal Index (ESJI) ve Türkiye Atıf Dizini'nde indekslenmektedir.

EBSCO, DOAJ, OAJI, ProQuest dizinlerine müracaat yapılmış olup, değerlendirme aşamasındadır.

Makaleler "Çift-Kör Hakem Değerlendirmesi”nden geçmektedir.

Üniversitelerarası Kurul (ÜAK) Eşdeğerliği: Ulakbim TR Dizin'de olan dergilerde yayımlanan makale [10 PUAN] ve 1a, b, c hariç uluslararası indekslerde (1d) olan dergilerde yayımlanan makale [5 PUAN].

Note: Our journal is not WOS indexed and therefore is not classified as Q.

You can download Council of Higher Education (CoHG) [Yüksek Öğretim Kurumu (YÖK)] Criteria) decisions about predatory/questionable journals and the author's clarification text and journal charge policy from your browser.  About predatory/questionable journals and journal charge policy

Not: Dergimiz WOS indeksli değildir ve bu nedenle Q  sınıflamasına dahil değildir.
Yağmacı/şüpheli dergilerle ilgili Yüksek Öğretim Kurumu (YÖK) kararları ve yazar açıklama metni ile dergi ücret politikası: Yağmacı/Şaibeli Dergiler ve Dergi Ücret Politikası