Artiko Vera, Odalovic Strahinja, Sobic-Saranovic Dragana, Petrovic Milorad, Stojiljkovic Milica, Petrovic Nebojsa, Kozarevic Nebojsa, Grozdic-Milojevic Isidora, Obradovic Vladimir
Center of Nuclear Medicine, Clinical Center of Serbia, Visegradska 26, 11000 Belgrade, Republic of Serbia.
Hell J Nucl Med. 2015 Jan-Apr;18(1):35-41.
To prospectively study whether in patients with resected primary colorectal cancer fluorine- 18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) examination could diagnose the stage, specify treatment procedure and be prognostic.
This prospective study included 75 patients with resected primary colorectal adenocarcinoma referred for (18)F-FDG PET/CT to the National PET Center, at the Clinical Center of Serbia, Belgrade, from January 2010 to May 2013. Findings of (18)F-FDG PET/CT were compared to findings of subsequent histopathological examinations or with results of clinical and imaging follow-up. Patients were followed after PET/CT examination for a mean follow-up time of 16.7±5.9 months.
In the detection of recurrent disease (18)F-FDG PET/CT showed overall sensitivity, specificity, PPV, NPV and accuracy of 96.6%, 82.4%, 94.9%, 87.5% and 93.3%, respectively. In the detection of stages I and II sensitivity, specificity and accuracy of (18)F-FDG PET/CT were: 88%, 96.6% and 94.7%, respectively, and in the detection of stages III and IV sensitivity, specificity and accuracy were 94.9%, 87.5% and 93.3%, respectively. These findings prevented or changed intended surgical treatment in 12/32 cases. Univariate and multivariate Cox proportional regression analyses revealed that metastatic recurrence (stages III and IV) was the only and independent prognostic factor of disease progression during follow-up (P=0.012 and P=0.023, respectively). Although, survival seemed better in patients with local recurrence compared to metastatic recurrent disease, this difference did not reach significance (Log-rank test; P=0.324). In addition, progression-free survival time was significantly longer in patients in whom (18)F-FDG PET/CT scan led to treatment changes (Log-rank test; P=0.037).
(18)F-FDG PET/CT was sensitive and accurate for the detection and staging of local and metastatic recurrent colorectal carcinoma, with higher specificity in the detection of local recurrences. The (18)F-FDG PET/CT scan induced treatment changes in 30/75 patients, including 12/32 patients in which surgical treatment was previously planned, and progression free survival time was significantly longer in these patients.
前瞻性研究氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（(18)F-FDG PET/CT）检查对已切除原发性结直肠癌患者进行分期、明确治疗方案及预后评估的作用。
这项前瞻性研究纳入了2010年1月至2013年5月间转诊至塞尔维亚贝尔格莱德临床中心国家PET中心接受(18)F-FDG PET/CT检查的75例已切除原发性结肠腺癌患者。将(18)F-FDG PET/CT的检查结果与后续组织病理学检查结果或临床及影像学随访结果进行比较。PET/CT检查后对患者进行随访，平均随访时间为16.7±5.9个月。
在复发性疾病检测中，(18)F-FDG PET/CT的总体敏感性、特异性、阳性预测值、阴性预测值和准确性分别为96.6%、82.4%、94.9%、87.5%和93.3%。在I期和II期检测中，(18)F-FDG PET/CT的敏感性、特异性和准确性分别为88%、96.6%和94.7%；在III期和IV期检测中，敏感性、特异性和准确性分别为94.9%、87.5%和93.3%。这些结果在12/32例患者中避免或改变了原定的手术治疗方案。单因素和多因素Cox比例回归分析显示，转移复发（III期和IV期）是随访期间疾病进展的唯一独立预后因素（分别为P=0.012和P=0.023）。尽管局部复发患者的生存率似乎高于转移复发患者，但差异无统计学意义（对数秩检验；P=0.324）。此外，(18)F-FDG PET/CT扫描导致治疗方案改变的患者无进展生存期明显更长（对数秩检验；P=0.037）。
(18)F-FDG PET/CT对局部和转移复发性结直肠癌的检测和分期敏感且准确，在检测局部复发方面具有更高的特异性。(18)F-FDG PET/CT扫描使75例患者中的30例治疗方案发生改变，其中包括12/32例原计划进行手术治疗的患者，这些患者的无进展生存期明显更长。
