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CURRENT ISSUETHE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

A Journal on Nuclear Medicine and Molecular Imaging


A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
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The Quarterly Journal of Nuclear Medicine 2001 September;45(3):215-30

PET IN ONCOLOGY
Guest Editor: I. Carrio 

The clinical application of positron emission tomography to colorectal cancer management

Arulampalam T. H. A. *, Costa D. C., Bomanji J. B., Ell P. J.

From the Insti­tute of ­Nuclear Med­i­cine and *Depart­ment of Sur­gery, ­Royal ­Free and Uni­ver­sity Col­lege Med­ical ­School, Mid­dlesex Hos­pital, ­London, UK

Color­ectal ­cancer (CRC) is the ­second com­monest ­cancer in the ­Western ­World. Suc­cessful treat­ment ­relies sig­nif­i­cantly on accu­rate detec­tion and ­staging of pri­mary dis­ease as ­well as the ­early iden­tifi­ca­tion of the pres­ence and ­extent of recur­rence. Mor­pho­log­ical ­imaging tech­niques, par­tic­u­larly com­puted tomog­raphy (CT), are ­well estab­lished and ­widely avail­able to ­carry out ­these ­tasks in addi­tion to pre­dicting and mon­i­toring ­response to ­therapy. ­This ­review anal­yses the cur­rent inad­e­qua­cies for ­imaging CRC and crit­i­cally ­assesses the poten­tial ­role of func­tional ­imaging ­with posi­tron emis­sion tomog­raphy (PET). We ­review the cur­rent lit­er­a­ture, use our expe­ri­ence ­from the ­first 1000 PET ­studies car­ried out at our Insti­tu­tion and the per­spec­tive of sur­gical col­leagues. We ­find ­little evi­dence for the use of 2-[18F]­fluoro-2-­deoxy-D-glu­cose (FDG)-PET for ­screening asymp­to­matic indi­vid­uals and cur­rent modal­ities ­appear ­better ­suited for detec­tion of symp­to­matic pri­mary CRC. ­There is evi­dence of ­increased accu­racy for FDG-PET in ­staging pri­mary dis­ease, but ­this ­area ­remains con­tro­ver­sial and ­larger ­studies are nec­es­sary. The sit­u­a­tion is ­quite the ­reverse ­with ­respect to ­imaging sus­pected recur­rent dis­ease ­with FDG-PET ­being ­more sen­si­tive and spe­cific ­than con­ven­tional tech­niques. ­This ben­efit man­i­fests ­itself ­through alter­a­tion in ­patient man­age­ment and ­results in ­cost sav­ings. PET ­also ­appears to ­have a spe­cific ­place in the eval­u­a­tion of ­patients under­going radio­therapy and chem­o­therapy, a ­role ­that ­will ­expand. The evi­dence sug­gests ­that PET ­will ulti­mately ­become rou­tinely incor­po­rated ­into CRC ­patient man­age­ment algo­rithms. Tech­no­log­ical ­advances cou­pled ­with ­novel ­tracer ­research ­will facil­i­tate ­this.

language: English


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