Annals of Coloproctology

Original Articles

Clinical Etiology of Hypermetabolic Pelvic Lesions in Postoperative Positron Emission Tomography/Computed Tomography for Patients With Rectal and Sigmoid Cancer: Yun Hee Kang, Eunji Han, Geon Park; Ann Coloproctol. 2018;34(2):78-82. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.09.21

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Purpose
The purpose of this study was to present various clinical etiologies of hypermetabolic pelvic lesions on postoperative positron emission tomography/computed tomography (PET/CT) images for patients with rectal and sigmoid cancer.
Methods
Postoperative PET/CT images for patients with rectal and sigmoid cancer were retrospectively reviewed to identify hypermetabolic pelvic lesions. Positive findings were detected in 70 PET/CT images from 45 patients; 2 patients who were lost to follow-up were excluded. All PET findings were analyzed in comparison with contrast-enhanced CT.
Results
A total of 43 patients were classified into 2 groups: patients with a malignancy including local recurrence (n = 30) and patients with other benign lesions (n = 13). Malignant lesions such as a local recurrent tumor, peritoneal carcinomatosis, and incidental uterine malignancy, as well as various benign lesions such as an anastomotic sinus, fistula, abscess, reactive lymph node, and normal ovary, were observed.
Conclusion
PET/CT performed during postoperative surveillance of rectal and sigmoid colon cancer showed increased fluorodeoxyglucose uptake not only in local recurrence, but also in benign pelvic etiologies. Therefore, physicians need to be cautious about the broad clinical spectrum of hypermetabolic pelvic lesions when interpreting images.

Citations

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Variants and Pitfalls in PET/CT Imaging of Gastrointestinal Cancers
Vetri Sudar Jayaprakasam, Viktoriya Paroder, Heiko Schöder
Seminars in Nuclear Medicine.2021; 51(5): 485. CrossRef

Reliability of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Nodal Staging of Colorectal Cancer Patients: Hee Jung Yi, Kyung Sook Hong, Nara Moon, Soon Sup Chung, Ryung-Ah Lee, Kwang Ho Kim; Ann Coloproctol. 2014;30(6):259-265. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.259

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Abstract PDF

Purpose

Lymph-node metastasis is considered as critical prognostic factor in colorectal cancer. A preoperative evaluation of lymph-node metastasis can also help to determine the range of distant lymph node dissection. However, the reliability of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of lymph-node metastasis is not fully known.

Methods

The medical records of 433 patients diagnosed with colorectal cancer were reviewed retrospectively. FDG-PET/CT and CT were performed on all patients. Lymph nodes were classified into regional and distant lymph nodes according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th edition.

Results

The patients included 231 males (53.3%) and 202 females (46.7%), with a mean age of 64.7 ± 19.0 years. For regional lymph nodes, the sensitivity of FDG-PET/CT was lower than that of CT (57.1% vs. 73.5%, P < 0.001). For distant lymph nodes, the sensitivity of FDG-PET/CT was higher than that of CT (64.7% vs. 52.9%, P = 0.012). The sensitivity of FDG-PET/CT for regional lymph nodes was higher in patients with larger primary tumors. The positivity of lymph-node metastasis for FDG-PET/CT was affected by carcinoembryonic antigen levels, tumor location, and cancer stage for regional lymph nodes and by age and cancer stage for distant lymph nodes (P < 0.05).

Conclusion

The sensitivity of FDG-PET/CT for regional lymph-node metastasis was not superior to that of CT. However, FDG-PET/CT provides helpful information for determining surgical plan especially in high risk patients group.

Citations

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Evaluation of colon cancer prognostic factors by CT and MRI: an up-to-date review
Ruggeri B. Guimarães, Eduardo O. Pacheco, Serli N. Ueda, Dario A. Tiferes, Fernanda L. Mazzucato, Aley Talans, Ulysses S. Torres, Giuseppe D’Ippolito
Abdominal Radiology.2024; 49(11): 4003. CrossRef
Can Cross-Sectional Imaging Reliably Determine Pathological Staging of Right-Sided Colon Cancers and Select Patients for More Radical Surgery or Neo-Adjuvant Treatment?
Florence Shekleton, Edward Courtney, Adrian Andreou, John Bunni
Cureus.2022;[Epub] CrossRef
Colorectal cancer: Parametric evaluation of morphological, functional and molecular tomographic imaging
Pier Paolo Mainenti, Arnaldo Stanzione, Salvatore Guarino, Valeria Romeo, Lorenzo Ugga, Federica Romano, Giovanni Storto, Simone Maurea, Arturo Brunetti
World Journal of Gastroenterology.2019; 25(35): 5233. CrossRef
Clinical evaluation of18F-fludeoxyglucose positron emission tomography/CT using point spread function reconstruction for nodal staging of colorectal cancer
Kazuya Kawashima, Kenichi Kato, Makiko Tomabechi, Mikaru Matsuo, Koki Otsuka, Kazuyuki Ishida, Ryuji Nakamura, Shigeru Ehara
The British Journal of Radiology.2016; 89(1063): 20150938. CrossRef
Short-term and oncologic outcomes of laparoscopic and open complete mesocolic excision and central ligation
Ik Yong Kim, Bo Ra Kim, Eun Hee Choi, Young Wan Kim
International Journal of Surgery.2016; 27: 151. CrossRef
Preoperative Staging With Positron Emission Tomography in Patients With Colorectal Cancer
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology.2014; 30(6): 247. CrossRef

Case Report

An Extragastrointestinal Stromal Tumor in the Omentum With Peritoneal Seeding Mimicking an Appendiceal Mucinous Cancer With Carcinomatosis: Jeonghyun Kang, Tae Joo Jeon, Sun Och Yoon, Kang Young Lee, Seung-Kook Sohn; Ann Coloproctol. 2014;30(2):93-96. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.93

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Abstract PDF

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. These tumors tend to present most frequently in the stomach, followed by the small intestine. GISTs can also arise from the omentum, retroperitoneum, mesentery, or pleura and are termed extragastrointestinal stromal tumors (EGISTs) when they do so. EGISTs arising from the omentum are very rare. Due to the limited incidence of EGISTs in the omentum, the diagnostic criteria are not well established, and making a correct diagnosis may be difficult. In this report, we present a case of an EGIST of the omentum with peritoneal metastasis that was initially suspected to be an appendiceal mucinous carcinoma with carcinomatosis on positron emission tomography/computed tomography imaging.

Citations

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Primary Extragastrointestinal Stromal Tumor of Greater Omentum with Intraperitoneal Bleeding
Masatoshi Kataoka, Tsukasa Saitoh, Kousaku Kawashima, Tomotaka Yazaki, Hiroki Sonoyama, Eiko Okimoto, Akihiko Oka, Yoshiyuki Mishima, Tsuyoshi Mishiro, Naoki Oshima, Kotaro Shibagaki, Hiroshi Tobita, Ichiro Moriyama, Norihisa Ishimura, Mamiko Nagase, Nori
Internal Medicine.2021; 60(21): 3413. CrossRef
Recurrent and metastatic extragastrointestinal stromal tumors of the mesentery with C-KIT and PDGFRA mutations: a case report
Huang Yayu, Zhang Changmao, Dai Yijun, Lin Na, Xu Tianwen, Dai Yangbin
Cancer Biology & Therapy.2020; 21(2): 101. CrossRef
Mucinous Carcinomatosis: A Rare Association between an Ovarian Tumor and an E-GIST
Hugo Palma Rios, André Goulart, Pedro Leão
Case Reports in Surgery.2018; 2018: 1. CrossRef
Extra-gastrointestinal stromal tumour. Report of primary tumour in the omentum
E.N. Valdes-Peregrina, M. Hernández-González, O. de León-Pacheco, S. Mendoza-Ramírez
Revista Médica del Hospital General de México.2018; 81(4): 221. CrossRef
Clinicopathological features and prognosis of omental gastrointestinal stromal tumor: evaluation of a pooled case series
Fan Feng, Yangzi Tian, Zhen Liu, Shushang Liu, Guanghui Xu, Man Guo, Xiao Lian, Daiming Fan, Hongwei Zhang
Scientific Reports.2016;[Epub] CrossRef

Original Articles

Positron Emission Tomography/Computed Tomography in the Staging of Colon Cancer: Jae Hyung Lee, Min Ro Lee; Ann Coloproctol. 2014;30(1):23-27. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.23

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Abstract PDF

Purpose
Accurate preoperative staging of colon cancer is essential for providing the optimal treatment strategy and evaluating the expected prognosis. The aim of this study is to assess the value of positron emission tomography/computed tomography (PET/CT) over conventional studies in the staging of colon cancer.
Methods
A total of 266 colon cancer patients diagnosed between January 2008 and December 2010 were assessed with both PET/CT and conventional studies. Discordance with PET/CT and conventional studies were evaluated, and changes in the management strategy were assessed for each stage. Discordant findings were verified by using intraoperative examination, pathology reports, and follow-up imaging studies.
Results
Multidetector computed tomography (MDCT) and PET/CT showed similar accuracy in detecting lymph node metastasis in patients with clinical stage III (36.2% vs. 42%, P = 0.822) and stage IV (60.3% vs. 63.5%, P = 0.509) disease. PET/CT led to a change in management strategy for 1 of 40 patients (2.5%) with clinical stage I, 0 of 25 patients (0%) with stage II, 9 of 138 patients (6.5%) with stage III, and 8 of 63 patients (12.7%) with stage IV disease.
Conclusion
PET/CT changed the management plan in 6.5% of patients with clinical stage III and 12.7% of patients with clinical stage IV colon cancer. Our findings suggest that PET/CT may be considered as a routine staging tool for clinical stage III and IV colon cancers.

Citations

Citations to this article as recorded by

Diagnostic role of F-18 FDG PET/CT in determining preoperative Lymph node status of patients with rectal cancer: a meta-analysis
Weili Ma, Bo Chen, Fandong Zhu, Chen Yang, Jianfeng Yang
Abdominal Radiology.2024; 49(6): 2125. CrossRef
Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment
Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Cha
Annals of Coloproctology.2024; 40(2): 89. CrossRef
Accuracy of pre‐operative 18‐fluoride fluorodeoxyglucose positron emission tomography (FDG‐PET) in predicting lymph node involvement in colon cancer
Chahaya Marc Gauci, Tae Jun Kim, Yijun Gao, Dayashan S. Perera
ANZ Journal of Surgery.2023; 93(11): 2675. CrossRef
Contribution of Metabolic Parameters and Pericolic Fat Stranding on Preoperative 18F-FDG PET/CT in Predicting Post-operative Histopathology and Outcome in Colorectal Cancer
Selin Soyluoglu, Busra Ozdemir Gunay
Nuclear Medicine and Molecular Imaging.2023; 57(5): 223. CrossRef
CT is unreliable in locoregional staging of early colon cancer: A nationwide registry-based study
Erik Wetterholm, Roberto Rosén, Milladur Rahman, Carl-Fredrik Rönnow
Scandinavian Journal of Surgery.2023; 112(1): 33. CrossRef
Diagnostic accuracy of ≥ 16-slice spiral computed tomography for local staging of colon cancer: A systematic review and meta-analysis
Dan Liu, Lin-Mei Sun, Jing-Hua Liang, Lei Song, Xiao-Pei Liu
World Journal of Clinical Cases.2022; 10(19): 6483. CrossRef
Clinical application and research advancement of positron emission tomography/computed tomography in colorectal cancer
Wu Cai-Xia, Wang Rong-Fu
World Chinese Journal of Digestology.2020; 28(18): 925. CrossRef
Is It Time to Introduce PET/CT in Colon Cancer Guidelines?
Anna Margherita Maffione, Domenico Rubello, Paola Caroli, Patrick M. Colletti, Federica Matteucci
Clinical Nuclear Medicine.2020; 45(7): 525. CrossRef
The role of PET/CT with 18F-fluorodeoxyglucose in detecting the progression of colorectal cancer in asymptomatic patients with elevated level of сarcinoembryonic antigen (literature review)
M. B. Dolgushin, A. I. Mikhaylov, S. S. Gordeev
Colorectal Oncology.2019; 9(2): 11. CrossRef
Morphological predictors for lymph node metastases on computed tomography in colon cancer
Erik Rollvén, Lennart Blomqvist, Emma Öistämö, Fredrik Hjern, György Csanaky, Mirna Abraham-Nordling
Abdominal Radiology.2019; 44(5): 1712. CrossRef
Colorectal Cancer:
Nathan C. Hall, Alexander T. Ruutiainen
Surgical Oncology Clinics of North America.2018; 27(2): 289. CrossRef
Assessment and diagnostic accuracy of lymph node status to predict stage III colon cancer using computed tomography
Erik Rollvén, Mirna Abraham-Nordling, Torbjörn Holm, Lennart Blomqvist
Cancer Imaging.2017;[Epub] CrossRef
Diagnostic Accuracy of CT for Local Staging of Colon Cancer: A Systematic Review and Meta-Analysis
Elias Nerad, Max J. Lahaye, Monique Maas, Patty Nelemans, Frans C. H. Bakers, Geerard L. Beets, Regina G. H. Beets-Tan
American Journal of Roentgenology.2016; 207(5): 984. CrossRef
Comparison of 18F-fluorodeoxyglucose PET/CT findings with vascular endothelial growth factors and receptors in colorectal cancer
Ahmet Kocael, Betül Vatankulu, Osman Şimşek, Mahir Cengiz, Ahu Kemik, Pınar Kocael, Metin Halaç, Kerim Sönmezoğlu, Kenan Ulualp
Tumor Biology.2016; 37(3): 3871. CrossRef
Metabolic Tumor Volume and Total Lesion Glycolysis in PET/CT Correlate With the Pathological Findings of Colorectal Cancer and Allow Its Accurate Staging
Yoshiyuki Suzuki, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Kohei Shigeta, Koji Murakami, Yuko Kitagawa
Clinical Nuclear Medicine.2016; 41(10): 761. CrossRef
Impact of Fluorodeoxyglucose PET/Computed Tomography on the Management of Patients with Colorectal Cancer
Sander Thomas Laurens, Wim J.G. Oyen
PET Clinics.2015; 10(3): 345. CrossRef
The Role of Positron Emission Tomography/Computed Tomography in the Initial Staging of Colon Cancer
Hyung Jin Kim, Seong Taek Oh
Annals of Coloproctology.2014; 30(1): 3. CrossRef
Preoperative Staging With Positron Emission Tomography in Patients With Colorectal Cancer
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology.2014; 30(6): 247. CrossRef

Positron Emission Tomography (PET)-Computed Tomography (CT) for Preoperative Staging of Colorectal Cancers.: Yoo, Joong Jae , Lee, Seung Hyun , Ahn, Byung Kwon , Baek, Sung Uhn , Lee, Seok Mo; J Korean Soc Coloproctol. 2008;24(3):201-206.; DOI: https://doi.org/10.3393/jksc.2008.24.3.201

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PURPOSE
The purpose of this study is to evaluate the usefulness of positron emission tomography (PET)-computed tomography (CT) for preoperative tumor staging in cases of colorectal cancer. METHODS: Between July 2006 and September 2007, seventy-six patients with a diagnosis of colorectal cancer (43 males and 33 females; mean age: 60.4+/-10.13 years; range: 34~82 years) selected prospectively were studied for staging by using Chest X-ray, abdominal CT and PET-CT. RESULTS: The sensitivities and the specificities for N-staging were 76.9% and 35.1% for CT, 61.8% and 66.7% for PET-CT, and both procedures showed a relatively low diagnostic accuracy (CT 57.9%, PET-CT 61.8%). In the PET-CT alone, six distant metastatic lesions and four multiple primary malignancies were found. The locations of the distant metastases were the liver, the axillary node, the common iliac node, the subclavicular node, the peritoneum, and the lung. The locations of the multiple primary maligancies in extracolonic sites were 3 in the thyroid and 1 in the nasopharynx. CONCLUSIONS: For N-staging, preoperative PET-CT is no more useful than CT, but PET-CT is required before surgery to find lesions that cannot be found with conventional studies.

Citations

Citations to this article as recorded by

Preoperative Staging With Positron Emission Tomography in Patients With Colorectal Cancer
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology.2014; 30(6): 247. CrossRef
The Usefulness of FDG-PET/CT for the Prediction of Regional Lymph Node Metastases in Colorectal Cancer
Mi Ji Bang, Sang Hun Jung, Jae Hwang Kim, Min Chul Shim
Journal of the Korean Surgical Society.2010; 79(1): 43. CrossRef

Clinical Usefulness of a PET Scan in the Diagnosis of a Recurrent Colorectal Carcinoma.: Park, In Ja , Yu, Chang Sik , Kim, Hee Cheol , Lee, Kang Hong , Ryu, Jin Suk , Ha, Hyun Kwon , Kim, Jin Cheon; J Korean Soc Coloproctol. 2004;20(2):99-104.

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Abstract PDF: PURPOSE
The aim of this study was to evaluate the potential efficacy of positron emission tomography using 2- [18F]-fluoro-2-deoxy-D-glucose in detecting recurrent colorectal carcinomas.
METHODS
Seventy patients suspected of having recurrent colon cancer were evaluated using PET from January 2001 to March 2003. The PET results were compared with those of computed tomography and clinical examination over 6 months.
RESULTS
Among the 70 patients, 17 patients had abnormal CEA levels and no abnormal findings with conventional radiologic methods (group 1), 29 had equivocal findings on computed tomography and other radiologic studies (group 2), and 24 were proven to have recurrent colorectal carcinoma (group 3) respectively. The sensitivity and the specificity of the PET scan, which were proved to be higher then those of CT (93% vs. 72.2%, 88% vs. 48.5%), were 85.7%, and 80%, respectively, in group 1, 86.7%, and 85.7% in group 2 and both 100% in group 3. The interval between diagnosis using PET and conventional studies was 1.9 months.
CONCLUSIONS
Positron emission tomography is more sensitive than computed tomography in detecting recurrent colorectal carcinomas. When conventional studies show no abnormal findings except for CEA levels, PET can be a valuable imaging tool in detecting recurrent colorectal cancer and can prevent other unnecessary exploratory procedures.

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