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
Article

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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

Keywords

PET CT Fusion image Local recurrence of rectal cancer 

Notes

Acknowledgments

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

References

  1. 1.
    Goldsmith, SJ, Kostakoglu, L 2002

    Nuclear medicine in the diagnosis, management of colorectal cancer

    Saltz, LB eds. Colorectal Cancer: Multimodality ManagementHumana PressTotowa, NJ157177
    Google Scholar
  2. 2.
    Wanebo, HJ, Koness, RJ, Vezeridis, MP, Cohen, SI, Wrobleski, DE 1994Pelvic resection of recurrent rectal cancerAnn Surg22058695PubMedGoogle Scholar
  3. 3.
    Suzuki, K, Dozois, RR, Devine, RM,  et al. 1996Curative reoperations for locally recurrent rectal cancerDis Colon Rectum397306PubMedGoogle Scholar
  4. 4.
    Freeny, PC, Marks, WM, Ryan, JA, Bolen, JW 1986Colorectal carcinoma evaluation with CT. preoperative staging and detection of postoperative recurrenceRadiology15834753PubMedGoogle Scholar
  5. 5.
    Chen, YM, Ott, DJ, Wolfman, NT, Gelfand, DW, Karsteadt, N, Bechtold, RE 1987Recurrent colorectal carcinoma: evaluation with barium enema examination and CTRadiology16330710PubMedGoogle Scholar
  6. 6.
    Moss, AA, Thoeni, RF, Schnyder, P, Margulis, AR 1981Value of computed tomography in the detection and staging of recurrent rectal carcinomasJ Comput Assist Tomogr58704PubMedGoogle Scholar
  7. 7.
    Krestin, GP, Steinbrich, W, Friedmann, G 1988Recurrent rectal cancer: diagnosis with MR imaging versus CTRadiology16830711PubMedGoogle Scholar
  8. 8.
    Lange, EE, Fechner, RE, Wanebo, HJ 1989Suspected recurrent rectosigmoid carcinoma after abdominoperineal resection: MR imaging and histopathologic findingsRadiology1703238PubMedGoogle Scholar
  9. 9.
    Ito, K, Kato, T, Tadokoro, M,  et al. 1992Recurrent rectal cancer and scar: differentiation with PET and MR imagingRadiology18254952PubMedGoogle Scholar
  10. 10.
    Schlag, P, Lehner, B, Strauss, LG, Georgi, P, Herfarth, C 1989Scar or recurrent rectal cancerPositron emission tomography is more helpful for diagnosis than immunoscintigraphy. Arch Surg 124197200Google Scholar
  11. 11.
    Keogan, MT, Lowe, VJ, Baker, ME, McDermott, VG, Lyerly, HK, Coleman, RE 1997Local recurrence of rectal cancer: evaluation with F-18 fluorodeoxyglucose PET imagingAbdom Imaging223327CrossRefPubMedGoogle Scholar
  12. 12.
    Fukunaga, H, Sekimoto, M, Tatsumi, M,  et al. 2002Clinical relevance of fusion images using 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography in local recurrence of rectal cancerInt J Oncol206915PubMedGoogle Scholar
  13. 13.
    Lardinois, D, Weder, W, Hany, TF,  et al. 2003Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomographyN Engl J Med34825007PubMedGoogle Scholar
  14. 14.
    Hany, TF, Steinert, HC, Goerres, GW, Buck, A, von Schulthess , GK 2002PET diagnostic accuracy: improvement with in-line PET-CT system: initial resultsRadiology22557581PubMedGoogle Scholar
  15. 15.
    Townsend, DW, Beyer, T 2002A combined PET/CT scanner: the path to true image fusionBr J Radiol75S2430PubMedGoogle Scholar
  16. 16.
    Takeuchi, O, Saito, N, Koda, K, Sarashina, H, Nakajima, N 1999Clinical assessment of positron emission tomography for the diagnosis of local recurrence in colorectal cancerBr J Surg869327CrossRefPubMedGoogle Scholar
  17. 17.
    Strauss, LG, Clorius, JH, Schlag, P,  et al. 1989Recurrence of colorectal tumors: PET evaluationRadiology17032932PubMedGoogle Scholar
  18. 18.
    Wolf, G, Nicoletti, R, Schultes, G, Schwarz, T, Schaffler, G, Aigner, RM 2003Preoperative image fusion of fluoro-2-deoxy-D-glucose-positron emission tomography and computed tomography data sets in oral maxillofacial carcinomaJ Comput Assist Tomogr2788995CrossRefPubMedGoogle Scholar
  19. 19.
    D’Amico, TA, Wong, TZ, Harpole, DH, Brown, SD, Coleman, RE 2002Impact of computed tomography-positron emission tomography fusion in staging patients with thoracic malignanciesAnn Thorac Surg741603CrossRefPubMedGoogle Scholar
  20. 20.
    Townsend, DW, Carney, JPJ, Yap, JT, Hall, NC 2004PET/CT today and tomorrowJ Nucl Med454S14SPubMedGoogle Scholar
  21. 21.
    Cohade, C, Osman, M, Leal, J, Wahl, RL 2003Direct comparison of 18F-FDG PET and PET/CT in patients with colorectal carcinomaJ Nucl Med441797803PubMedGoogle Scholar
  22. 22.
    Minsky BD. Management of locally unresectable rectal cancer. In: Saltz LB (ed). Colorectal Cancer: Multimodality Management Humana Press, Totowa NJ. 20931.Google Scholar
  23. 23.
    Saito, N, Koda, K, Takiguchi, N,  et al. 2003Curative surgery for local pelvic recurrence of rectal cancerDig Surg201929CrossRefPubMedGoogle Scholar
  24. 24.
    Huguier, M, Houry, S, Barrier, A 2001Local recurrence of cancer of the rectumAm J Surg1824379CrossRefPubMedGoogle Scholar
  25. 25.
    Farouk, R, Nelson, H, Radice, E, Mercill, S, Gunderson, L 1998Accuracy of computed tomography in determining resectability for locally advanced primary or recurrent colorectal cancersAm J Surg1752837CrossRefPubMedGoogle Scholar
  26. 26.
    Valk, PE, Abella, CE, Haseman, MK,  et al. 1999Whole-body PET imaging with [18F]fluorodeoxyglucose in management of recurrent colorectal cancerArch Surg13450311CrossRefPubMedGoogle Scholar
  27. 27.
    Lonneux, M, Reffad, AM, Detry, R, Kartheuser, A, Gigot, JF, Pauwels, S 2002FDG-PET improves the staging and selection of patients with recurrent colorectal cancerEur J Nucl Med Mol Imaging2991521CrossRefPubMedGoogle Scholar
  28. 28.
    Desai, DC, Zervos, EE, Arnold, MW, Burak, WJ, Mantil, J, Martin, EJ 2003Positron emission tomography affects surgical management in recurrent colorectal cancer patientsAnn Surg Oncol105964CrossRefPubMedGoogle Scholar
  29. 29.
    Staib, L, Schirrmeister, H, Reske, SN, Beger, HG 2000Is 18F-fluorodeoxyglucose positron emission tomography in recurrent colorectal cancer a contribution to surgical decision making?Am J Surg18015CrossRefPubMedGoogle Scholar
  30. 30.
    Arulampalam, T, Costa, D, Visvikis, D, Boulos, P, Taylor, I, Ell, P 2001The impact of FDG-PET on the management algorithm for recurrent colorectal cancerEur J Nucl Med28175865CrossRefPubMedGoogle Scholar
  31. 31.
    Kalff, V, Hicks, RJ, Ware, RE, Hogg, A, Binns, D, McKenzie, AF 2002The clinical impact of 18F-FDG PET in patients with suspected or confirmed recurrence of colorectal cancer: a prospective studyJ Nucl Med434929PubMedGoogle Scholar
  32. 32.
    Flamen, P Stroobants, S CE et al. 1999Additional value of whole-body positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose in recurrent colorectal cancerJ Clin Oncol17894901PubMedGoogle Scholar
  33. 33.
    Gordon, BA, Flanagan, FL, Dehdashati, F 1997Whole-body positron emission tomography: normal variations, pitfalls, and technical considerationAJR Am J Roentgenol169167580PubMedGoogle Scholar

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

Personalised recommendations