Intest Res  
Diagnostic and prognostic value of preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography for colorectal cancer: comparison with conventional computed tomography
Joo Young Lee,1 Soon Man Yoon,1 Jeong Tae Kim,1 Ki Bae Kim,1 Mi Jin Kim,1 Jae Geun Park,1 Taek-Gu Lee,2 Sang-Jeon Lee,2 Sung Soo Koong,3 Joung-Ho Han,1 Hee Bok Chae,1 Seon Mee Park,1 Sei Jin Youn1
Departments of 1Internal Medicine, 2Surgery, and 3Nuclear Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
Correspondence to: Soon Man Yoon, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju 28644, Korea. Tel: +82-43-269-7241, Fax: +82-43-273-3252, E-mail: smyoon@chungbuk.ac.kr
Received: May 9, 2016; Revised: August 14, 2016; Accepted: September 21, 2016; Published online: March 7, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been used for preoperative staging of colorectal cancer (CRC). However, the diagnostic accuracy of FDG-PET/CT for detection of lymph node or distant metastases and its prognostic role have not been well established. We therefore evaluated the diagnostic and prognostic value of FDG-PET/CT in comparison with conventional CT for CRC. Methods: We investigated 220 patients who underwent preoperative FDG-PET/CT and CT, followed by curative surgery for CRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET/CT and CT for detection of lymph node metastases and distant metastases were evaluated. In addition, we assessed the findings of FDG-PET/CT and CT according to outcomes, including cancer recurrence and cancer-related death, for evaluation of prognostic value. Results: For detection of lymph node metastases, FDG-PET/CT had a sensitivity of 44%, a specificity of 84%, and an accuracy of 67%, compared with 59%, 65%, and 62%, respectively, for CT (P =0.029, P =0.000, P =0.022). For distant metastases, FDG-PET/CT had a sensitivity of 79%, a specificity of 94%, and an accuracy of 93%, compared with 79%, 87%, and 86%, respectively, for CT (P =1.000, P =0.004, P =0.037). In addition, positive findings of lymph node metastases and distant metastases on FDG-PET/CT were associated significantly with cancer recurrence or cancer-related death (P =0.009, P =0.001, respectively). Conclusions: Preoperative FDG-PET/CT had a higher specificity and accuracy compared to CT for detection of lymph node metastases and distant metastases of CRC. In addition, FDG-PET/CT could be a valuable prognostic tool for CRC.
Keywords: Positron-emission tomography; Computed tomography; Colorectal neoplasms; Diagnosis; Prognosis


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