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Does positron emission tomography/computed tomography change management in colorectal cancer?
Rachel Falconer1, Saxon Connor1, Adrian Balasingam2
1Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand.
Background:
Positron emission tomography/computed tomography (PET/CT) is used pre-operatively in patients with metastatic or recurrent colorectal cancer to identify those who have potentially curative disease. However, a recent randomized trial questioned the added benefit of PET/CT over conventional imaging in patients with liver metastases. The aim of this study was to determine the proportion of patients with colorectal cancer in whom PET/CT altered surgical management, in a single tertiary centre.
Methods:
This was a retrospective study of all patients with colorectal cancer who had a PET/CT for colorectal cancer, funded by the Canterbury District Health Board between 2010 and 2014.
Results:
Some 111 PET/CT scans were performed on 105 patients. A total of 38% of PET/CT were for patients with known or suspected liver metastases, 23% for suspected local recurrence and 18% for known or suspected lung metastases. Five scans were for post-operative patients with a rising carcinoembryonic antigen and no attributable source on conventional imaging. PET/CT identified additional extrahepatic sites of disease in 19 of 111 (17%) scans in patients deemed to have potentially operable disease. Overall, PET/CT altered surgical management following six of 42 (14%) scans for patients with liver metastases, four of 20 (20%) scans for patients with lung metastases and six of 26 (23%) scans for patients with local recurrence.
Conclusion:
PET/CT remains a useful adjunct to conventional imaging in the pre-operative workup of patients with colorectal cancer.
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