18 F-FDG PET/CT for restaging, guiding therapeutic strategy and predicting prognosis in patients with postoperative colorectal cancer
10.3760/cma.j.issn.2095-2848.2017.10.003
- VernacularTitle:18 F-FDG PET/CT对结直肠癌术后患者临床再分期、治疗策略及预后评估的价值
- Author:
Yuqi LIU
1
,
2
;
215003 苏州大学附属儿童医院放射科
;
Bin ZHANG
;
Shengming DENG
;
Zhenxin WANG
;
Mao SHENG
Author Information
1. 215006 苏州大学附属第一医院核医学科
2. 215003 苏州大学附属儿童医院放射科
- Keywords:
Colorectal neoplasms;
Neoplasm staging;
Prognosis;
Positron-emission tomography;
Tomography,X-ray computed;
Deoxyglucose
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2017;37(10):613-617
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical value of 18 F-FDG PET/CT for restaging, guiding therapeutic strategy and predicting prognosis in patients with postoperative colorectal cancer (PCC). Methods Records of 91 patients (51 males, 40 females;average age (54.90±11.47) years) in whom PCC were eval-uated by 18 F-FDG PET/CT imaging from May 2010 to June 2014 were retrospectively reviewed. All patients underwent evaluation at the First Affiliated Hospital of Soochow University. 18 F-FDG PET/CT results were compared with the results from pathological examination, clinical long-term follow-up (≥6 months ) and conventional imaging. Diagnostic efficiency of 18 F-FDG PET/CT in detecting recurrence and metastases of PCC were calculated. The clinical value of 18 F-FDG PET/CT in restaging and guiding therapeutic strategy were analyzed in patients with true positive results. Kaplan-Meier survival analysis was conducted based on the results of PET/CT and the alteration of therapeutic strategy after PET/CT. Results The sensitivity, specific-ity, accuracy, positive predictive value and negative predictive value of 18 F-FDG PET/CT were 96. 36%(53/55), 83.33%(30/36), 91.21%(83/91), 89.83%(53/59) and 93.75%(30/32), respectively. The median survival time and the 5-year survival rate were 10.00 years and 84% in patients with true negative PET/CT results, and were 6. 33 years and 53% in true positive group. Patients with true negative results showed longer OS and PFS than those with true positive results (χ2=7.753, 8. 933, both P<0.01). Among the 53 patients with true positive PET/CT results, tumor restaging was up-regulated in 32 patients and down-regulated in 2 patients. Therapeutic strategies were changed in 33 patients, in whom the PFS was lon- ger than those without treatment alteration (χ2=4.905, P<0.05) . Conclusion 18 F-FDG PET/CT imaging has the high sensitivity and accuracy in detecting recurrence and metastasis of PCC, with the potential for altering clinical restaging and therapeutic strategy timely.
