PET in Colorectal Cancer. Indications for FDG PET Rising marker, (-) CT/MRI Nonspecific findings on CT/MRI, recurrence or post treatment changes? Known.
Post on 12-Jan-2016
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PET in Colorectal Cancer
Indications for FDG PET
• Rising marker, (-) CT/MRI• Nonspecific findings on CT/MRI, recurrence or post treatment changes?• Known metastases; evaluate extent or disease or identify other sites of recurrence• Evaluate response to chemotherapy
LV
12/09/9304/23/9608/22/96
PET-FDG SCAN IN RECTAL CA
191642
Coronal
MSKCC AL361200
Case 1Case 1Case 1
Comparison of PET and CT
N=40 pts. (93 biopsies)
WCT=0.73+/-.06*
WPET=0.97/-.02*
*P<.001
Biopsy Correlated Finding SUV in Colon Cancer
0.00
0.20
0.40
0.60
0.80
1.00
0 1 2 3 4 5 6 7 8 9
PET-FDG SUV
Fra
cti
on
of
PE
T F
ind
ing
s
FPF
TPF
PET in Colorectal Cancer
0
0.1
0.20.3
0.4
0.5
0.6
0.70.8
0.9
1
0.00 0.20 0.40 0.60 0.80 1.00
Prevalence of Disease
Pos
t-tes
t Dis
ease
pro
babi
lity
T+/D+
T-/D+
Change: post vs pre
Diagnostic Imaging in Oncology• Detection
• Differential Diagnosis
• Tumor biology relevant to therapy
• Staging
• Recurrence
• Response
PET in Colorectal Cancer• PET accuracy between 88 - 92% > CT (75%)• Among pt.s with suspected recurrence, SUV > 3.5
has a 90% probability of tumor, and a 10% prob of being a benign lesion
• Most common reasons for missing lesions is size (< 1 cm in diameter), location (peritoneum), and artifact (lesion near high count area)
• PET >> CT for Rx response in rectal Ca
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