Advanced search
2 files | 2.05 MB

Differentiation between peri-anastomotic inflammatory changes and local recurrence following neoadjuvant radiochemotherapy surgery for colorectal cancer using visual and semiquantitative analysis of PET-CT data

Peter Smeets (UGent) , Hamphrey Ham (UGent) , Wim Ceelen (UGent) , Tom Boterberg (UGent) , Koenraad Verstraete (UGent) and Ingeborg Goethals (UGent)
Author
Organization
Abstract
Aim. The aim of this study was to evaluate the usefulness of visual and semiquantitative [F-18]fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) data for the diagnosis of peri-anastomotic colorectal cancer recurrence, taking into account the time period between surgery and [F-18]FDG PET-CT scanning. Methods. The study population consisted of 70 patients who had prior preoperative radiochemotherapy and surgical resection of the primary tumor and who underwent whole body [F-18]FDG PET-CT scanning for the detection of recurrent disease. Visual and semiquantitative (SUVmax) analysis of [F-18]FDG uptake at the peri-anastomosis was performed. The final diagnosis was based on pathological proof or clinical and/or imaging follow-up data. Results. On visual reading, 27 patients exhibited increased [F-18]FDG uptake at the peri-anastomosis. Of these, 11 (41%) patients had a local tumor recurrence and 16 (59%) had no recurrent tumor. Among the 43 patients without increased [F-18]FDG uptake at the peri-anastomosis, none had local tumor recurrence. On semiquantitation, SUVmax in patients with and without a local recurrence overlapped. However, when the time period between surgery and [F-18]FDG PET-CT scanning was taken into account, overlap of SUVmax was mainly observed within a postoperative period of <= 12 months; thereafter, a threshold SUVmax of 3.2 discriminated between benign and malignant lesions in all but one patient. Conclusion. In our series, visually increased [F-18]FDG uptake at the peri-anastomosis was 100% sensitive but non-specific (73% specificity) for the diagnosis of local tumor recurrence. On the other hand, normal [F-18]FDG uptake at the peri-anastomosis precluded a local tumor recurrence (a negative predictive value of 100%). In addition, semiquantitative (SUVmax) analysis of [F-18]FDG uptake at the peri-anastomosis may increase specificity (up to 97%), while preserving maximum sensitivity, if the postoperative period is >12 months.
Keywords
POSITRON-EMISSION-TOMOGRAPHY, PRACTICE GUIDELINE, ROI DEFINITION, Positron-emission tomography, Computed tomography, surgical, Fluorodeoxyglucose F18, Anastomosis, Colorectal neoplasms, CARCINOMA, RESOLUTION, PATTERNS, RECONSTRUCTION, TRIALS, UPTAKE VALUES, CURATIVE RESECTION

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 101.71 KB
  • Smeets P.pdf
    • full text
    • |
    • open access
    • |
    • PDF
    • |
    • 1.94 MB

Citation

Please use this url to cite or link to this publication:

Chicago
Smeets, Peter, Hamphrey Ham, Wim Ceelen, Tom Boterberg, Koenraad Verstraete, and Ingeborg Goethals. 2010. “Differentiation Between Peri-anastomotic Inflammatory Changes and Local Recurrence Following Neoadjuvant Radiochemotherapy Surgery for Colorectal Cancer Using Visual and Semiquantitative Analysis of PET-CT Data.” Quarterly Journal of Nuclear Medicine and Molecular Imaging 54 (3): 327–332.
APA
Smeets, P., Ham, H., Ceelen, W., Boterberg, T., Verstraete, K., & Goethals, I. (2010). Differentiation between peri-anastomotic inflammatory changes and local recurrence following neoadjuvant radiochemotherapy surgery for colorectal cancer using visual and semiquantitative analysis of PET-CT data. QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 54(3), 327–332.
Vancouver
1.
Smeets P, Ham H, Ceelen W, Boterberg T, Verstraete K, Goethals I. Differentiation between peri-anastomotic inflammatory changes and local recurrence following neoadjuvant radiochemotherapy surgery for colorectal cancer using visual and semiquantitative analysis of PET-CT data. QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. 2010;54(3):327–32.
MLA
Smeets, Peter, Hamphrey Ham, Wim Ceelen, et al. “Differentiation Between Peri-anastomotic Inflammatory Changes and Local Recurrence Following Neoadjuvant Radiochemotherapy Surgery for Colorectal Cancer Using Visual and Semiquantitative Analysis of PET-CT Data.” QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 54.3 (2010): 327–332. Print.
@article{1261245,
  abstract     = {Aim. The aim of this study was to evaluate the usefulness of visual and semiquantitative [F-18]fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) data for the diagnosis of peri-anastomotic colorectal cancer recurrence, taking into account the time period between surgery and [F-18]FDG PET-CT scanning.
Methods. The study population consisted of 70 patients who had prior preoperative radiochemotherapy and surgical resection of the primary tumor and who underwent whole body [F-18]FDG PET-CT scanning for the detection of recurrent disease. Visual and semiquantitative (SUVmax) analysis of [F-18]FDG uptake at the peri-anastomosis was performed. The final diagnosis was based on pathological proof or clinical and/or imaging follow-up data.
Results. On visual reading, 27 patients exhibited increased [F-18]FDG uptake at the peri-anastomosis. Of these, 11 (41\%) patients had a local tumor recurrence and 16 (59\%) had no recurrent tumor. Among the 43 patients without increased [F-18]FDG uptake at the peri-anastomosis, none had local tumor recurrence. On semiquantitation, SUVmax in patients with and without a local recurrence overlapped. However, when the time period between surgery and [F-18]FDG PET-CT scanning was taken into account, overlap of SUVmax was mainly observed within a postoperative period of {\textlangle}= 12 months; thereafter, a threshold SUVmax of 3.2 discriminated between benign and malignant lesions in all but one patient.
Conclusion. In our series, visually increased [F-18]FDG uptake at the peri-anastomosis was 100\% sensitive but non-specific (73\% specificity) for the diagnosis of local tumor recurrence. On the other hand, normal [F-18]FDG uptake at the peri-anastomosis precluded a local tumor recurrence (a negative predictive value of 100\%). In addition, semiquantitative (SUVmax) analysis of [F-18]FDG uptake at the peri-anastomosis may increase specificity (up to 97\%), while preserving maximum sensitivity, if the postoperative period is {\textrangle}12 months.},
  author       = {Smeets, Peter and Ham, Hamphrey and Ceelen, Wim and Boterberg, Tom and Verstraete, Koenraad and Goethals, Ingeborg},
  issn         = {1824-4661},
  journal      = {QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING},
  keyword      = {POSITRON-EMISSION-TOMOGRAPHY,PRACTICE GUIDELINE,ROI DEFINITION,Positron-emission tomography,Computed tomography,surgical,Fluorodeoxyglucose F18,Anastomosis,Colorectal neoplasms,CARCINOMA,RESOLUTION,PATTERNS,RECONSTRUCTION,TRIALS,UPTAKE VALUES,CURATIVE RESECTION},
  language     = {eng},
  number       = {3},
  pages        = {327--332},
  title        = {Differentiation between peri-anastomotic inflammatory changes and local recurrence following neoadjuvant radiochemotherapy surgery for colorectal cancer using visual and semiquantitative analysis of PET-CT data},
  volume       = {54},
  year         = {2010},
}

Web of Science
Times cited: