Annals of Surgical Oncology

, Volume 12, Issue 7, pp 561–569 | Cite as

Fusion Image of Positron Emission Tomography and Computed Tomography for the Diagnosis of Local Recurrence of Rectal Cancer

  • Hiroki Fukunaga
  • Mitsugu Sekimoto
  • Masataka Ikeda
  • Ichiro Higuchi
  • Masayoshi Yasui
  • Iwao Seshimo
  • Osamu Takayama
  • Hirofumi Yamamoto
  • Masayuki Ohue
  • Mitsuaki Tatsumi
  • Jun Hatazawa
  • Masakazu Ikenaga
  • Tsunehiko Nishimura
  • Morito Monden



The aim of this study was to evaluate the clinical and therapeutic value of digital fusion image (FI) of positron emission tomography (PET) using 18F-fluorodeoxy glucose and computed tomography (CT) in patients who were suspected of having a local recurrence of rectal cancer.


Forty-two patients (32 men and 10 women; mean age, 61.4 years, range, 40–79 years) with a suspicion of local recurrence after curative resection of rectal cancer were prospectively recruited and underwent 18F-fluorodeoxy glucose-PET and CT. The FI was reconstructed with a commercially available digital software program, T-B Fusion. Wilcoxon signed rank test was used to compare FI with CT alone or PET alone.


FI yielded a correct diagnosis in 39 (93%) of 42 patients, whereas CT alone and PET alone did so in 33 (79%) and 37 (88%) patients, respectively. FI had better diagnostic accuracy than CT alone (P = .0138) and PET alone (P = .0156). Overall, FI altered patient management in 11 (26.2%) patients on the basis of additional information, including differentiation of the tumor from the postoperative scar in 6 patients, exact anatomical location in 3 patients, and both in 2 patients.


FI has a potential clinical value in the treatment of suspected local recurrence of rectal cancer.


PET CT Fusion image Local recurrence of rectal cancer 



The authors thank Dr. Tadaaki Yamada, Shionogi & Co., Ltd., Department of Biostatistics, for technical assistance regarding statistical analysis.


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Copyright information

© The Society of Surgical Oncology, Inc. 2005

Authors and Affiliations

  • Hiroki Fukunaga
    • 1
  • Mitsugu Sekimoto
    • 1
  • Masataka Ikeda
    • 1
  • Ichiro Higuchi
    • 1
  • Masayoshi Yasui
    • 1
  • Iwao Seshimo
    • 1
  • Osamu Takayama
    • 1
  • Hirofumi Yamamoto
    • 1
  • Masayuki Ohue
    • 1
  • Mitsuaki Tatsumi
    • 2
  • Jun Hatazawa
    • 2
  • Masakazu Ikenaga
    • 3
  • Tsunehiko Nishimura
    • 4
  • Morito Monden
    • 1
  1. 1.Department of Surgery and Clinical Oncology (E2)Graduate School of Medicine, Osaka UniversityOsakaJapan
  2. 2. Department of Nuclear Medicine and Tracer Kinetics (D9), Graduate School of MedicineOsaka UniversityJapan
  3. 3.Department of SurgeryOsaka National HospitalOsakaJapan
  4. 4.Department of RadiologyGraduate School of Medical Science, Kyoto Prefectural University of MedicineKamigyoJapan

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