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Pitfalls and mimickers on (18)F-FDG-PET/CT in peritoneal carcinomatosis from colorectal cancer: An analysis from 37
R Audollent1, C Eveno2, A Dohan3
1Surgical Oncologic and Digestive Unit, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Paris-Diderot, Sorbonne Paris Cité, 10, rue de Verdun, 75010 Paris, France.
Background:
Optimal selection is critical in patients with peritoneal carcinomatosis (PC) in whom curative cytoreductive surgery can be anticipated. (18)F-FDG-PET/CT may result in false-positive findings that may eliminate patients for whom cytoreductive surgery would be beneficial.
Objectives:
To determine the rate of false-positive findings on (18)F-FDG-PET/CT and clarify their causes in patients with suspected PC from colorectal cancer.
Methods:
A retrospective analysis of 37 patients with suspected PC from colorectal cancer who had (18)F-FDG-PET/CT before cytoreductive surgery was performed to determine the rate and the causes of false-positive findings. (18)F-FDG-PET/CT was considered falsely positive when no tumor was found at surgery, histopathological analysis and follow-up.
Results:
False-positive findings were observed in four patients, yielding a 11% (95%CI: 3-25%) false-positive rate on a per-patient basis. The causes of false-positives were elucidated in two patients (surgical mesh after umbilical hernia repair and one foreign body granuloma).
Conclusion:
False-positive findings on (18)F-FDG-PET/CT are observed in 11% of patients with suspected PC from colorectal cancer. Familiarity with false-positive findings would result in more accurate selection of patients candidates to cytoreductive surgery.
