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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Dual-time point images of the liver with 18F-FDG PET/CT in suspected recurrence ...
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Vol. 31. Issue 3.
Pages 111-116 (May - June 2012)
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Vol. 31. Issue 3.
Pages 111-116 (May - June 2012)
Original article
Dual-time point images of the liver with 18F-FDG PET/CT in suspected recurrence from colorectal cancer
18F-FDG PET/TC con imagen hepática en dos tiempos en la sospecha de recidiva del cáncer colorrectal
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D. Fustera,b,
Corresponding author
dfuster@clinic.ub.es

Corresponding author.
, S. Lafuentea, X. Setoaina,b,c, I. Navalesa, A. Perissinottia, J. Paviaa,b,c, P. Paredesa, F. Lomeñaa, F. Ponsa,b
a Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, Spain
b Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
c Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
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Table 1. Clinical characteristics of the patients.
Table 2. Concordance of the PET/CT findings in patients with a diagnosis of liver metastasis between the standard and delayed images and between the two images with the definitive diagnosis.
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Abstract
Aim

To analyze the potential improvement of 18F-fluorodeoxyglucose (FDG) PET/CT using additional delayed images of the liver in operated colorectal cancer.

Material and methods

The study prospectively included 71 patients (22 women, 49 men) with mean age of 65±11 years with clinical, biochemical or radiological suspicion of current disease. A whole body PET/CT scan was performed at 60min (standard images) and after 2h (delayed images) post-injection of 4.07MBq/kg of 18F-FDG. Visual and quantitative SUV analysis of PET/CT findings were done. All findings were confirmed by histopathology and/or at least 6 months follow-up.

Results

Thirty-seven out of 71 patients were diagnosed of liver metastases (79 metastases). In 38/71 cases there was extra-hepatic disease in the form of local recurrence (10), abdominopelvic (3) or mediastinal (3) lymph nodes, bone (1) or lung metastases (16) and carcinomatosis (10). Sensitivity and specificity for the diagnosis of liver metastases in a patient-by-patient basis in standard (81% and 91%) and in delayed images (95% and 97%) were calculated. The number of lesions detected in delayed images was significantly higher (66/79) than in standard images (57/79). Sensitivity and specificity for PET/CT in the diagnosis of extra-hepatic disease were 84% and 70%, contributing to the detection of synchronous tumors in 5 patients.

Conclusions

PET/CT may be useful in the diagnosis of extra-hepatic disease in suspected recurrence of colorectal cancer. Delayed images on PET/CT may increase the sensitivity to identify liver metastases.

Keywords:
Colorectal cancer
Liver metastasis
PET/CT
Delayed images
Recurrence
Resumen
Objetivo

Analizar el potencial de la PET/TC usando imagen tardía del hígado en pacientes con sospecha de recidiva de cáncer colorrectal.

Material y métodos

Se han incluido prospectivamente 71 pacientes (22 mujeres, 49 hombres) con edad de 65±11 años y sospecha clínica, analítica o radiológica de recurrencia. Se realizó PET/TC después de la inyección de 4,07MBq/kg de 18F-FDG con imagen de cuerpo entero a los 60min (imagen estándar) y hepática a las 2h (imagen tardía). Se efectuó análisis visual y cuantitativo mediante SUV de los hallazgos de la PET/TC. Se obtuvo confirmación de las lesiones por estudio histopatológico y/o seguimiento mínimo de 6 meses.

Resultados

Se diagnosticaron metástasis hepáticas en 37/71 pacientes (79 metástasis). Un total de 38/71 pacientes mostraban enfermedad extra-hepática en forma de recidiva local (10), adenopatías abdominopélvicas (3) o mediastínicas (3), metástasis óseas (1) o pulmonares (16) y carcinomatosis (10). Se calculó la sensibilidad y especificidad para el diagnóstico de metástasis hepáticas en base a cada paciente para la imagen estándar (81 y 91%) y la imagen tardía (95 y 97%). El número de metástasis hepáticas diagnosticadas fue mayor con la imagen tardía (66/79) que con la imagen estándar (57/79). La sensibilidad y especificidad de la PET/TC en lesiones extra-hepáticas fue de 84 y 70%, contribuyendo al diagnóstico no sospechado de 5 tumores sincrónicos.

Conclusiones

La PET/TC es recomendable para descartar enfermedad extra-hepática en sospecha de recidiva de cáncer colorrectal. La realización de imagen tardía mejora la sensibilidad de la PET/TC en el diagnóstico de metástasis hepáticas.

Palabras clave:
Cáncer colorrectal
Metástasis hepáticas
PET/TC
Imagen tardía
Recidiva

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