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Kim and Kim: Preoperative Staging With Positron Emission Tomography in Patients With Colorectal Cancer
See Article on Page [Related article:] 259-265
The current National Comprehensive Cancer Network guideline for colon and rectal cancer designates that positron emission tomography-computed tomography (PET-CT) does not supplant a contrast-enhanced diagnostic CT scan. PET-CT should only be used to evaluate an equivocal finding on a contrast-enhanced CT scan or in patients with strong contraindications to IV contrast [1, 2]. In addition, as of 2015, the Korea Health Insurance Review & Assessment Service will not pay for PET-CT as a routine follow-up test. In this regard, colorectal surgeons should be cautious when planning PET-CT as an initial staging modality in clinical practice.
PET is a promising tool as a preoperative imaging modality for colorectal cancer, but still lacks firm evidence supporting its use as a routine test. In this issue of the Annals of Coloproctology, Yi et al. [3] demonstrated effectively that preoperative PET-CT is useful in detecting regional and distant node metastasis in patients with colon cancer. Previously, Yoo et al. [4] had observed that preoperative PET-CT was useful in the detection of synchronous distant metastases (7.8%) and multiple primary malignancies (5.3%) in patients with colorectal cancer. Lee and Lee [5] also showed that preoperative use of PET-CT had resulted in a change in the treatment plan in 7% of colon-cancer patients when compared to the use of multidetector CT. In a recent meta-analysis, PET-CT showed, on a per patient basis, the highest sensitivity (94.1%) for the initial detection of liver metastases when compared to CT (83.6%) and magnetic resonance imaging (88.2%) [6]. All these retrospective findings are valuable; however, before the preoperative use of PET-CT can be incorporated into clinical practice, such use must be validated through large prospective trials.

References

1. National Comprehensive Cancer Network. Rectal cancer (Version 1.2015)[Internet]. Fort Washington, PA: National Comprehensive Cancer Network; c2014.cited 2014 Dec 19. Available from: http://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf
pmid
2. National Comprehensive Cancer Network. Colon cancer (Version 2.2015)[Internet]. Fort Washington, PA: National Comprehensive Cancer Network; c2014.cited 2014 Dec 19. Available from: http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf
pmid
3. Yi HJ, Hong KS, Moon N, Chung SS, Lee RA, Kim KH. Reliability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the nodal staging of colorectal cancer patients. Ann Coloproctol 2014;30:259–265.
crossref pmid pmc
4. Yoo JJ, Lee SH, Ahn BK, Baek SU, Lee SM. Positron emission tomography (PET)-computed tomography (CT) for preoperative staging of colorectal cancers. J Korean Soc Coloproctol 2008;24:201–206.
crossref
5. Lee JH, Lee MR. Positron emission tomography/computed tomography in the staging of colon cancer. Ann Coloproctol 2014;30:23–27. PMID: 24639967.
crossref pmid pmc
6. Niekel MC, Bipat S, Stoker J. Diagnostic imaging of colorectal liver metastases with CT, MR imaging, FDG PET, and/or FDG PET/CT: a meta-analysis of prospective studies including patients who have not previously undergone treatment. Radiology 2010;257:674–684. PMID: 20829538.
crossref pmid


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