Predictors of initial 18F-fluorodeoxyglucose-positron emission tomography indication among patients with colorectal cancer

Nucl Med Commun. 2012 Jul;33(7):739-46. doi: 10.1097/MNM.0b013e328353b249.


Objectives: To evaluate the determinants of initial F-fluorodeoxyglucose (F-FDG)-PET indication following primary colorectal cancer diagnosis among patients who underwent surgery between January 2000 and December 2007 and who were observed at a single institution for at least 2 years after diagnosis.

Methods: Of the 530 patients who underwent colorectal cancer resection, 113 patients received at least one F-FDG-PET following diagnosis. Outcome variables included indication and time of the first F-FDG-PET following diagnosis. Potential predictors included disease-level and patient-level characteristics. Univariate and multivariate regression analyses were performed.

Results: Patients diagnosed later in the study period and patients with higher-stage disease were more likely to receive their first F-FDG-PET for initial staging (P<0.001 and P=0.016, respectively). Patients with lower-stage disease were more likely to receive their initial F-FDG-PET for suspected recurrence on conventional imaging. When performed more than 2 years after diagnosis, F-FDG-PET was more likely to be ordered for suspected recurrence either on the basis of conventional imaging or on the basis of patient symptoms/tumor markers (P=0.003 and 0.031, respectively). F-FDG-PET demonstrated disease progression in at least 50% of patients referred for each indication (P=0.037).

Conclusion: Higher utilization of F-FDG-PET may be appropriate among patients referred for a number of indications including: initial staging, particularly among those with higher-stage disease; suspected recurrence on conventional imaging among patients with lower-stage disease; and suspected recurrence more than 2 years after diagnosis. Further research is needed to verify these findings.

Publication types

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

MeSH terms

  • Aged
  • Colorectal Neoplasms / diagnostic imaging*
  • Female
  • Fluorodeoxyglucose F18*
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals*
  • Treatment Outcome


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18