Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Presumed Localized Colon Cancer: A Prospective Study with Long-Term Follow-Up
We analyzed whether preoperative <sup>18</sup>F-FDG PET/CT adds to conventional primary staging in patients with presumed non-metastatic colonic cancer (CC). The prognostic role of <sup>18</sup>F-FDG uptake in the primary tumor was evaluated after a mean follow-up of 15 years...
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MDPI AG
2024-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/1/233 |
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| author | Samuel Aymard Edmond Rust Ashjan Kaseb David Liu Fabrice Hubele Benoit Romain Gerlinde Averous Cecile Brigand Alessio Imperiale |
| author_facet | Samuel Aymard Edmond Rust Ashjan Kaseb David Liu Fabrice Hubele Benoit Romain Gerlinde Averous Cecile Brigand Alessio Imperiale |
| author_sort | Samuel Aymard |
| collection | DOAJ |
| description | We analyzed whether preoperative <sup>18</sup>F-FDG PET/CT adds to conventional primary staging in patients with presumed non-metastatic colonic cancer (CC). The prognostic role of <sup>18</sup>F-FDG uptake in the primary tumor was evaluated after a mean follow-up of 15 years. Patients with a new diagnosis of presumed localized CC were prospectively enrolled and underwent presurgical <sup>18</sup>F-FDG PET/CT. For each colon lesion, SUVmax, SUVpeak, TLG, and MTV were assessed and tested as prognostic factors. Forty-eight patients were included. Post-surgery pathology identified a total of 103 colon lesions, including 58 invasive adenocarcinomas, 4 in situ adenocarcinomas, 3 adenomas with high-grade dysplasia, and 38 adenomas with low-grade dysplasia. Per lesion sensitivity, specificity, positive (PPVs) and negative predictive values (NPVs) for colonic primary tumor detection were 78%, 97%, 98%, and 73% for conventional workup, and 94%, 87%, 92%, and 89% for <sup>18</sup>F-FDG PET/CT. Only sensitivity was significantly different between <sup>18</sup>F-FDG PET/CT and conventional workup. PET detected an additional ten pathological colonic lesions in seven patients. SUVmax, SUVpeak, and TLG showed significant differences between invasive adenocarcinomas, in situ adenocarcinomas, and high-grade dysplasia compared to low-grade dysplasia. There was a statistically significant difference between pT1-pT2 and pT3-pT4 adenocarcinomas. On patient-based analysis, sensitivity, specificity, PPV, and NPV for nodal staging were 22%, 84%, 44%, and 65% for CECT, and 33%, 90%, 67%, and 70% for <sup>18</sup>F-FDG PET/CT, without a statistically significant difference. PET/CT also identified unknown metastatic spread and one synchronous lung cancer in four patients. Overall, <sup>18</sup>F-FDG PETCT had an additional diagnostic value in 11 out of 48 patients (23%). <sup>18</sup>F-FDG uptake of the primary tumor did not predict nodal or distant metastases. The difference in disease-free survival categorized by median SUVmax, SUVpeak, TLG, and MTV was not significant. Finally, preoperative <sup>18</sup>F-FDG PET/CT is valuable in detecting potential colon lesions not visualized by conventional workups, especially in cases of incomplete colonoscopy. It effectively highlights distant metastases but exhibits limitations for N staging. Mainly due to the relatively small sample size, the quantitative analysis of <sup>18</sup>F-FDG uptake in the primary tumor did not reveal any association with recurrence or disease-free survival, adding no significant prognostic information. |
| first_indexed | 2024-03-08T15:10:34Z |
| format | Article |
| id | doaj.art-94e3a136ace848738714cb4f9fbe0664 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-08T15:10:34Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-94e3a136ace848738714cb4f9fbe06642024-01-10T14:53:08ZengMDPI AGCancers2072-66942024-01-0116123310.3390/cancers16010233Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Presumed Localized Colon Cancer: A Prospective Study with Long-Term Follow-UpSamuel Aymard0Edmond Rust1Ashjan Kaseb2David Liu3Fabrice Hubele4Benoit Romain5Gerlinde Averous6Cecile Brigand7Alessio Imperiale8Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67033 Strasbourg, FranceNuclear Medicine, Fondation de la Maison du Diaconat, 68200 Mulhouse, FranceNuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67033 Strasbourg, FranceDigestive and General Surgery, University Hospitals of Strasbourg, 67098 Strasbourg, FranceNuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67033 Strasbourg, FranceDigestive and General Surgery, University Hospitals of Strasbourg, 67098 Strasbourg, FrancePathology, Strasbourg University Hospitals, 67098 Strasbourg, FranceDigestive and General Surgery, University Hospitals of Strasbourg, 67098 Strasbourg, FranceNuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, 67033 Strasbourg, FranceWe analyzed whether preoperative <sup>18</sup>F-FDG PET/CT adds to conventional primary staging in patients with presumed non-metastatic colonic cancer (CC). The prognostic role of <sup>18</sup>F-FDG uptake in the primary tumor was evaluated after a mean follow-up of 15 years. Patients with a new diagnosis of presumed localized CC were prospectively enrolled and underwent presurgical <sup>18</sup>F-FDG PET/CT. For each colon lesion, SUVmax, SUVpeak, TLG, and MTV were assessed and tested as prognostic factors. Forty-eight patients were included. Post-surgery pathology identified a total of 103 colon lesions, including 58 invasive adenocarcinomas, 4 in situ adenocarcinomas, 3 adenomas with high-grade dysplasia, and 38 adenomas with low-grade dysplasia. Per lesion sensitivity, specificity, positive (PPVs) and negative predictive values (NPVs) for colonic primary tumor detection were 78%, 97%, 98%, and 73% for conventional workup, and 94%, 87%, 92%, and 89% for <sup>18</sup>F-FDG PET/CT. Only sensitivity was significantly different between <sup>18</sup>F-FDG PET/CT and conventional workup. PET detected an additional ten pathological colonic lesions in seven patients. SUVmax, SUVpeak, and TLG showed significant differences between invasive adenocarcinomas, in situ adenocarcinomas, and high-grade dysplasia compared to low-grade dysplasia. There was a statistically significant difference between pT1-pT2 and pT3-pT4 adenocarcinomas. On patient-based analysis, sensitivity, specificity, PPV, and NPV for nodal staging were 22%, 84%, 44%, and 65% for CECT, and 33%, 90%, 67%, and 70% for <sup>18</sup>F-FDG PET/CT, without a statistically significant difference. PET/CT also identified unknown metastatic spread and one synchronous lung cancer in four patients. Overall, <sup>18</sup>F-FDG PETCT had an additional diagnostic value in 11 out of 48 patients (23%). <sup>18</sup>F-FDG uptake of the primary tumor did not predict nodal or distant metastases. The difference in disease-free survival categorized by median SUVmax, SUVpeak, TLG, and MTV was not significant. Finally, preoperative <sup>18</sup>F-FDG PET/CT is valuable in detecting potential colon lesions not visualized by conventional workups, especially in cases of incomplete colonoscopy. It effectively highlights distant metastases but exhibits limitations for N staging. Mainly due to the relatively small sample size, the quantitative analysis of <sup>18</sup>F-FDG uptake in the primary tumor did not reveal any association with recurrence or disease-free survival, adding no significant prognostic information.https://www.mdpi.com/2072-6694/16/1/233coloncarcinomapresurgicalsurgerystaging<sup>18</sup>F-FDG |
| spellingShingle | Samuel Aymard Edmond Rust Ashjan Kaseb David Liu Fabrice Hubele Benoit Romain Gerlinde Averous Cecile Brigand Alessio Imperiale Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Presumed Localized Colon Cancer: A Prospective Study with Long-Term Follow-Up Cancers colon carcinoma presurgical surgery staging <sup>18</sup>F-FDG |
| title | Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Presumed Localized Colon Cancer: A Prospective Study with Long-Term Follow-Up |
| title_full | Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Presumed Localized Colon Cancer: A Prospective Study with Long-Term Follow-Up |
| title_fullStr | Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Presumed Localized Colon Cancer: A Prospective Study with Long-Term Follow-Up |
| title_full_unstemmed | Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Presumed Localized Colon Cancer: A Prospective Study with Long-Term Follow-Up |
| title_short | Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Presumed Localized Colon Cancer: A Prospective Study with Long-Term Follow-Up |
| title_sort | preoperative sup 18 sup f fdg pet ct in patients with presumed localized colon cancer a prospective study with long term follow up |
| topic | colon carcinoma presurgical surgery staging <sup>18</sup>F-FDG |
| url | https://www.mdpi.com/2072-6694/16/1/233 |
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