The impact of FDG-PET on the management algorithm for recurrent colorectal cancer

Eur J Nucl Med. 2001 Dec;28(12):1758-65. doi: 10.1007/s002590100646. Epub 2001 Oct 20.


Positron emission tomography (PET) has been successfully used to image colorectal cancer (CRC). This study evaluated the accuracy of 2-[(18)F]-fluoro-2-deoxy- D-glucose (FDG) PET for the detection and staging of recurrent CRC and the consequent impact on clinical management. Forty-two patients previously treated for CRC were investigated for suspected recurrence and, if recurrence was confirmed, the extent of disease was evaluated. All patients underwent whole-body FDG-PET and computed tomography (CT) scan and results were compared to assess sensitivity, specificity and diagnostic accuracy for each modality. We then assessed the FDG-PET directed alteration in clinical management from that planned on the basis of spiral CT results. FDG-PET was more sensitive (93%) than CT (73%) for detection of recurrence (specificity 58% and 75%, respectively). FDG-PET yielded a correct diagnosis in 35 (83%) out of 42 patients, while CT did so in 31 patients (74%). FDG-PET was more accurate than CT for staging local recurrence (sensitivity 100%, specificity 86% with FDG-PET vs 75% and 100%, respectively, with CT) and CRC liver metastases (sensitivity 100% vs 45%; specificity 100% for both). Overall, PET upstaged 8 out of 30 patients (27%) and altered patient management in 16 (38%) cases. This study confirms that FDG-PET is more sensitive than CT for the detection and staging of recurrent CRC. The results also indicate that FDG-PET is an accurate means of selecting appropriate patients for operative treatment. When applied to routine clinical practice, patient management is altered.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms*
  • Colorectal Neoplasms / diagnostic imaging*
  • Colorectal Neoplasms / therapy*
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Male
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Neoplasm Recurrence, Local / therapy*
  • Predictive Value of Tests
  • Radiopharmaceuticals*
  • Sensitivity and Specificity
  • Tomography, Emission-Computed*
  • Tomography, X-Ray Computed


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18