Kolorektal kanserlerin yeniden evrelemesinde F-18 FDG PET/BT’nin önemi

Giriş: Bu çalışmada, kolorektal kanserli hastalarda, uygulanan cerrahi, kemoterapi, radyoterapi sonrası takip döneminde hastalığın nüksünü düşündürür belirti ve bulgu varlığında nüksü doğrulamak ve hastalığın yayılım bölgelerini saptamak için yapılan yeniden evrelemede F-18 FDG PET/BT’nin öneminin saptanması amaçlanmıştır. Bunun için PET/BT görüntüleri, BT görüntüleri ile karşılaştırılmış ve serum CEA düzeyi ile görüntüleme yöntemlerinin uyumu incelenmiştir. Ayrıca, yeniden evrelemede patolojik bulgu saptanan hastalarda uygulanan tedavi sonrası tedaviye cevabın belirlenmesinde PET/BT’nin rolü de araştırılmıştır. Gereç ve Yöntem: Retrospektif olarak yapılan bu çalışmaya, 102 hasta dahil edilmiştir. Tüm hastalara yeniden evrelendirme amacıyla F-18 FDG ile PET/BT görüntülemesi yapılmış olup PET/BT sonuçları, eş zamanlı olarak yapılan BT, serum CEA düzeyi ve klinik, eğer varsa histopatolojik incelemenin sonuçları ile karşılaştırılmıştır. Bulgular: Çalışmada, nüks şüphesi olan kolorektal kanserli olgularda, PET/BT’nin patoloji saptama oranı %98, BT’nin ise %64,7 olarak hesaplanmıştır. BT’de patoloji izlenmeyen 34 hastada PET/BT ile patolojik lezyonların görüntülenebildiği, serum CEA düzeyi normal olan 70 hastanın 68’inde PET/BT ile, 45’inde ise BT ile patolojik lezyonun lokalize edildiği görülmüştür. Yapılan değerlendirmede, nüks hastalığın saptanmasında PET/BT’nin BT’den daha başarılı olduğu sonucuna ulaşılmıştır. Sonuç: Bu bilgiler ışığında, takip döneminde nüks şüphesi olan kolorektal kanserli olguların yeniden evrelemesinde ve sonrasında yapılan tedavinin etkinliğinin değerlendirilmesinde F-18 PET/BT’nin yararlı olduğu sonucuna ulaşılmıştır.

Anahtar Kelimeler:

Kolorektal kanser, PET/BT, BT, yeniden evreleme

The Impact Of F-18 FDG PET/CT In the restaging of colorectal cancer in patients with suspected recurrence

Aim: The aim of the present study is to investigate the impact of F-18 FDG PET/CT in the restaging of colorectal cancer in patients with suspected recurrence. Thus, PET/CT findings were compared with that of CT. In addition, the correlation between serum CEA levels and PET/CT and CT findings was investigated. Furthermore, the role of PET/CT in treatment response among patients who were treated after restaging was assessed. Material and Method: In this retrospective study, a total of 102 patients operated for colorectal cancer (63 female, 39 male, mean age 65.81±4.63 years) were investigated. F-18 FDG PET/CT scans were acquired in all patients. The findings of PET/CT were compared with that of concurrent CT, and also with CEA levels. Results: In the study, the success rates of PET/CT and CT in detecting pathologic lesions in colorectal cancer cases with suspected recurrence were 98% and 64.7%, respectively. In 34 cases, pathologic lesions were detected with PET/CT, while CT showed no recurrence. The lesions of 68 cases out of 70 with high CEA levels were localized by means of PET/CT, whereas pathology was observed by CT in only 45 cases. Thus, PET/CT was considered more successful than CT in detecting recurrence. In the liver where lesion was localized the most, the sensitivity and specificity of PET/CT were 88% and 92%, respectively, while the sensitivity and specificity of CT were 80% and 76%, respectively. Conclusion: In the light of findings, our study suggested PET/CT as a valuable imaging tool for restaging and treatment response assessment in colorectal cancer cases with suspected recurrence.

Keywords:

Colorectal cancer, F-18 FDG PET/CT, CT, restaging,

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