Guney Isa Burak, Teke Zafer, Kucuker Kadir Alper, Yalav Orcun
Ann Ital Chir. 2020;91:658-667.
In patients with colorectal cancer an accurate diagnostic work-up is mandatory in order to perform the most specific treatment. In this study, we aimed to evaluate the accuracy of computed tomography (CT), magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detection of regional lymph node metastases (RLNMs) and the additional value of PET/CT in the preoperative staging of colorectal cancer.
From June 2015 to May 2018, 72 colorectal cancer patients were preoperatively examined using CT, MRI, and PET/CT. Histopathological examination of regional lymph nodes were performed in 53 patients who underwent colorectal surgery. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) of CT, MRI, and PET/CT for RLNMs, and the additional value of PET/CT in distant metastases were determined.
There were 44 male and 28 female in our study. The mean age was 61±11 years. Histopathologically, 27 patients (51%) were negative and 26 patients (49%) were positive for RLNMs. The sensitivity, specificity, PPV, NPV, and ACC of PET/CT were 88.5%, 59.3%, 67.6%, 84.2%, and 73.6%, respectively. PET/CT changed the patient management with diagnostic contribution to the suspicious lesions identified by radiological imaging modalities.
PET/CT is a useful tool in the evaluation of colorectal cancer, and it allows to metabolically characterize undetermined lesions suspected for recurrence of disease, to perform a complete pre-surgical staging and to identify occult metastatic disease. PET/CT should be considered an essential diagnostic tool in the management of patients with colorectal cancer, especially in the preoperative staging.
Colorectal Cancer, Computed tomography, Magnetic resonance imaging, Positron emission tomography.
对于结直肠癌患者，必须进行准确的诊断性检查以实施最具针对性的治疗。在本研究中，我们旨在评估计算机断层扫描（CT）、磁共振成像（MRI）和18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）检测区域淋巴结转移（RLNMs）的准确性以及PET/CT在结直肠癌术前分期中的附加价值。
2015年6月至2018年5月，对72例结直肠癌患者进行了CT、MRI和PET/CT术前检查。对53例行结直肠手术的患者进行了区域淋巴结的组织病理学检查。确定了CT、MRI和PET/CT对RLNMs的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性（ACC），以及PET/CT在远处转移方面的附加价值。
本研究中有44例男性和28例女性。平均年龄为61±11岁。组织病理学检查显示，27例患者（51%）RLNMs为阴性，26例患者（49%）为阳性。PET/CT的敏感性、特异性、PPV、NPV和ACC分别为88.5%、59.3%、67.6%、84.2%和73.6%。PET/CT改变了患者的治疗方案，对影像学检查发现的可疑病变有诊断贡献。
PET/CT是评估结直肠癌的有用工具，它能够对怀疑疾病复发的未确定病变进行代谢特征分析，进行完整的术前分期并识别隐匿性转移疾病。PET/CT应被视为结直肠癌患者管理中的重要诊断工具，尤其是在术前分期方面。
结直肠癌；计算机断层扫描；磁共振成像；正电子发射断层扫描
