Reliability of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Nodal Staging of Colorectal Cancer Patients
이희정, 홍경숙, 문나라, 정순섭, 이령아, 김광호,
소속 상세정보
이희정 ( Yi Hee-Jung )
Ewha Womans University School of Medicine Department of Surgery
홍경숙 ( Hong Kyung-Sook )
Ewha Womans University School of Medicine Department of Surgery
문나라 ( Moon Na-Ra )
Ewha Womans University School of Medicine Department of Surgery
정순섭 ( Chung Soon-Sup )
Ewha Womans University School of Medicine Department of Surgery
이령아 ( Lee Ryung-Ah )
Ewha Womans University School of Medicine Department of Surgery
김광호 ( Kim Kwang-Ho )
Ewha Womans University School of Medicine Department of Surgery
KMID : 0356720140300060259
Abstract
Purpose: Lymph-node metastasis is considered as critical prognostic factor in colorectal cancer. A preoperative evaluation of lymph-node metastasis can also help to determine the range of distant lymph node dissection. However, the reliability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of lymph-node metastasis is not fully known.
Methods: The medical records of 433 patients diagnosed with colorectal cancer were reviewed retrospectively. FDG-PET/CT and CT were performed on all patients. Lymph nodes were classified into regional and distant lymph nodes according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th edition.
Results: The patients included 231 males (53.3%) and 202 females (46.7%), with a mean age of 64.7 ± 19.0 years. For regional lymph nodes, the sensitivity of FDG-PET/CT was lower than that of CT (57.1% vs. 73.5%, P < 0.001). For distant lymph nodes, the sensitivity of FDG-PET/CT was higher than that of CT (64.7% vs. 52.9%, P = 0.012). The sensitivity of FDG-PET/CT for regional lymph nodes was higher in patients with larger primary tumors. The positivity of lymph-node metastasis for FDG-PET/CT was affected by carcinoembryonic antigen levels, tumor location, and cancer stage for regional lymph nodes and by age and cancer stage for distant lymph nodes (P < 0.05).
Conclusion: The sensitivity of FDG-PET/CT for regional lymph-node metastasis was not superior to that of CT. However, FDG-PET/CT provides helpful information for determining surgical plan especially in high risk patients group.
키워드
Colorectal neoplasms; Positron emission tomography; Lymph node; Metastasis
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