Nagata Koichi, Ota Yoshiko, Okawa Tomohiko, Endo Shungo, Kudo Shin-ei
Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
Dis Colon Rectum. 2008 Jun;51(6):882-90. doi: 10.1007/s10350-008-9236-1. Epub 2008 Mar 11.
This study was designed to evaluate the usefulness of 18-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) colonography in preoperative diagnosis of the tumors proximal to obstructive colorectal cancers, which were defined as cancers that cannot be traversed colonoscopically.
A whole-body PET/CT protocol for tumor staging and a protocol for CT colonography were integrated into one examination. No cathartic bowel preparation was used before this examination. Thirteen prospective patients with obstructive cancer were examined. We compared the detection rates for obstructive colorectal cancers and tumors proximal to the obstruction using air-inflated PET/CT colonography to intraoperative examinations, histopathologic outcome, and follow-up colonoscopy.
PET/CT colonography correctly identified all 13 primary obstructive colorectal cancers and all 2 synchronous colon cancers proximal to the obstruction. The two synchronous colon cancers detected at PET/CT colonography were confirmed and removed at single-stage surgical procedures. PET/CT colonography was able to localize all colorectal cancers precisely. There were no false-negative or false-positive proximal colorectal cancers by PET/CT colonography. Other preoperative examinations missed the synchronous colon cancers.
In patients with obstructive colorectal cancers, preoperative PET/CT colonography provided valuable anatomic and functional information of the entire colon to properly address surgery of colorectal cancer.
本研究旨在评估18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）结肠成像在术前诊断梗阻性结直肠癌近端肿瘤（定义为结肠镜无法通过的癌症）中的作用。
将用于肿瘤分期的全身PET/CT方案和CT结肠成像方案整合为一次检查。本次检查前未进行肠道清洁准备。对13例前瞻性梗阻性癌症患者进行了检查。我们将充气式PET/CT结肠成像对梗阻性结直肠癌及梗阻近端肿瘤的检出率与术中检查、组织病理学结果及随访结肠镜检查进行了比较。
PET/CT结肠成像正确识别了所有13例原发性梗阻性结直肠癌以及所有2例梗阻近端的同时性结肠癌。PET/CT结肠成像检测到的2例同时性结肠癌在一期手术中得到确认并切除。PET/CT结肠成像能够精确地定位所有结直肠癌。PET/CT结肠成像未出现近端结直肠癌的假阴性或假阳性结果。其他术前检查遗漏了同时性结肠癌。
对于梗阻性结直肠癌患者，术前PET/CT结肠成像可提供整个结肠的有价值的解剖和功能信息，以妥善处理结直肠癌手术。
