A case-controlled study of 18-fluorodeoxyglucose positron emission tomography in the detection of pelvic recurrence in previously irradiated rectal cancer patients Journal Article
| Authors: | Moore, H. G.; Akhurst, T.; Larson, S. M.; Minsky, B. D.; Mazumdar, M.; Guillem, J. G. |
| Article Title: | A case-controlled study of 18-fluorodeoxyglucose positron emission tomography in the detection of pelvic recurrence in previously irradiated rectal cancer patients |
| Abstract: | BACKGROUND: Although effective at detecting locally recurrent colorectal cancer, the accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for detecting rectal cancer recurrence in an irradiated pelvis has not been systematically studied. STUDY DESIGN: Records of surgically resected rectal cancer patients who underwent FDG-PET imaging at least 6 months after external beam radiation therapy (EBRT) were reviewed. Cases (n = 19) were defined as scans from patients in whom a pelvic recurrence was confirmed (histologically, n = 14, radiologic followup, n = 5). Controls (n = 41), defined as scans from patients without clinical or radiologic evidence of pelvic recurrence, were compared with cases for the time interval between completion of EBRT and FDG-PET imaging (RT/PET interval, mean 25.1 months versus 27.5 months, respectively), as well as EBRT dose (mean 5,084 cGy versus 5,062 cGy, respectively). All 60 FDG-PET scans were iteratively reconstructed and reinterpreted by a single nuclear medicine physician blinded to original FDG-PET interpretation and disease status. Certainty of disease was scored on a five-point scale (1 to 5), with scores greater than or equal to 4 considered positive. RESULTS: FDG-PET correctly identified 16 of 19 recurrences, for a sensitivity of 84% and specificity of 88%. Overall accuracy was 87%. Positive predictive value was 76% and negative predictive value was 92%. Positive predictive value and accuracy improved in scans performed more than 12 months after EBRT. CONCLUSIONS: Our preliminary data suggest that FDG-PET is an accurate modality for detecting pelvic recurrence of rectal cancer after full-dose EBRT. Its reliability appears to improve with time, perhaps because of resolution of early postradiation inflammation. © 2003 by the American College of Surgeons. |
| Keywords: | controlled study; treatment outcome; major clinical study; case-control studies; radiation dose; positron emission tomography; recurrent cancer; pelvis; diagnostic accuracy; sensitivity and specificity; radiopharmaceuticals; neoplasm recurrence, local; inflammation; diagnostic imaging; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; pelvic neoplasms; predictive value of tests; radiation beam; rectal neoplasms; rectum cancer; tomography, emission-computed; humans; human; male; female; priority journal; article |
| Journal Title: | Journal of the American College of Surgeons |
| Volume: | 197 |
| Issue: | 1 |
| ISSN: | 1072-7515 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2003-07-01 |
| Start Page: | 22 |
| End Page: | 28 |
| Language: | English |
| DOI: | 10.1016/s1072-7515(03)00337-5 |
| PUBMED: | 12831920 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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