Positron emission tomography/computed tomography for optimized colon cancer staging and follow up

Bodil Elisabeth Engelmann, Annika Loft, Andreas Kjær, Hans Jørgen Nielsen, Anne Kiil Berthelsen, Tina Binderup, Kim Brinch, Nils Brünner, Thomas Alexander Gerds, Gunilla Høyer-Hansen, Michael Holmsgaard Kristensen, Engin Yeter Kurt, Jan Erik Latocha, Gunnar Lindblom, Carsten Sloth, Liselotte Højgaard

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24 Citations (Scopus)

Abstract

OBJECTIVES: Optimal management of colon cancer (CC) requires detailed assessment of extent of disease. This study prospectively investigates the diagnostic accuracy of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (PET/CT) for staging and detection of recurrence in primary CC.

MATERIAL AND METHODS: PET/CT for preoperative staging was performed in 66 prospectively included patients with primary CC. Diagnostic accuracy for PET/CT and CT was analyzed. In addition to routine follow up, 42 stages I-III CC patients had postoperative PET/CT examinations every 6 months for 2 years. Serological levels of tissue inhibitor of metalloproteinase-1 (TIMP-1), carcinoembryonic antigen, and liberated domain I of urokinase plasminogen activator receptor were analyzed.

RESULTS: Accuracy for tumor, nodal, and metastases staging by PET/CT were 82% (95% confidence interval [CI]: 70; 91), 66% (CI: 51; 78), and 89% (CI: 79; 96); for CT the accuracy was 77% (CI: 64; 87), 60% (CI: 46; 73), and 69% (CI: 57; 80). Cumulative relapse incidences for stages I-III CC at 6, 12, 18, and 24 months were 7.1% (CI: 0; 15); 14.3% (CI: 4; 25); 19% (CI: 7; 31), and 21.4% (CI: 9; 34). PET/CT diagnosed all relapses detected during the first 2 years. High preoperative TIMP-1 levels were associated with significant hazards toward risk of recurrence and shorter overall survival.

CONCLUSIONS: This study indicates PET/CT as a valuable tool for staging and follow up in CC. TIMP-1 provided prognostic information potentially useful in selection of patients for intensive follow up.

Original languageEnglish
Book seriesScandinavian Journal of Gastroenterology
Volume49
Issue number2
Pages (from-to)191-201
Number of pages11
ISSN0085-5928
DOIs
Publication statusPublished - Feb 2014

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