Unnecessary surgery can be avoided by judicious use of PET/CT scanning in colorectal cancer patients.

AIM

This study aims to determine the role of positron emission tomography (PET)/computed tomography (CT) in changing the management plan in patients with metastatic or recurrent colorectal cancer (CRC) and to evaluate the role of PET/CT in patients with an unexplained rise in carcinoembryonic antigen (CEA).

MATERIALS AND METHODS

A total of 60 consecutive patients with CRC, who had PET/CT, were identified between 2008 and 2010. All patients had CT scans prior to the PET/CT. Data were collected from clinic letters, CT and PET CT reports and pathology results and cross-checked with the patient's notes.

RESULTS

Patients were aged between 43 and 85 years [33 males, 27 females]. CEA was raised in 37 patients and normal in 23. Results of PET/CT were compared with that of CT scan and 33 out of the 60 patients (55%) had PET/CT results which were different to that of CT scan and 27 patients (45%) had similar PET/CT and CT results. PET scan appropriately altered the management in 23/60 patients (38%) and avoided unnecessary surgery in 14 patients. PET/CT had a sensitivity of 86% and specificity of 84%. In patients with an unexplained rise in CEA, PET/CT was positive in only one out of ten (10%) patients.

CONCLUSION

PET/CT is valuable in deciding the management outcome in patients with metastatic or recurrent colorectal cancer. Unnecessary surgery might be avoided by careful use of PET/CT scanning in colorectal cancer patients. PET/CT might not be of value in patients with an unexplained rise in CEA.