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Non-enhanced CT versus contrast-enhanced CT in integrated PET/CT studies for nodal staging of rectal cancer
- Source :
- European Journal of Nuclear Medicine and Molecular Imaging. 34:1627-1634
- Publication Year :
- 2007
- Publisher :
- Springer Science and Business Media LLC, 2007.
-
Abstract
- The purpose of the present study was to determine the diagnostic accuracy of non-enhanced CT and contrast-enhanced CT in integrated PET/CT studies for preoperative nodal staging of rectal cancer.Retrospective analysis was performed in 53 patients with pathologically proven rectal cancer who had been referred for preoperative staging. All patients underwent integrated PET/CT consisting of non-enhanced and contrast-enhanced CT followed by whole-body fluorine-18-fluorodeoxyglucose ([(18)F]FDG) PET. Both non-enhanced and contrast-enhanced PET/CT images were evaluated separately by two observers in consensus. The reference standard was histopathologic results. For nodal staging of rectal cancer, we compared diagnostic accuracy on a per-patient basis between the two modalities.Nodal staging was correctly determined with non-enhanced studies in 37 patients (70%) and with contrast-enhanced studies in 42 patients (79%). On a per-patient basis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of regional lymph node staging were 85%, 68%, 83%, 72%, and 79%, respectively, with contrast-enhanced studies, and 85%, 42%, 73%, 62%, and 70%, respectively, with non-enhanced studies. The difference in the accuracy of nodal staging between the two modalities was not significant (p = 0.063). Compared with non-enhanced studies, contrast-enhanced studies determined more correctly the status of pararectal lymph nodes (p = 0.002), internal iliac lymph nodes (p = 0.004), and obturator lymph nodes (p0.0001).Contrast-enhanced PET/CT is superior to non-enhanced PET/CT for precise definition of regional nodal status in rectal cancer.
- Subjects :
- Adult
Male
medicine.medical_specialty
Enhanced ct
Colorectal cancer
Contrast Media
Nodal staging
Sensitivity and Specificity
medicine
Humans
Radiology, Nuclear Medicine and imaging
Stage (cooking)
Aged
Neoplasm Staging
PET-CT
Rectal Neoplasms
business.industry
Reproducibility of Results
Cancer
General Medicine
Middle Aged
medicine.disease
Radiographic Image Enhancement
Lymphatic Metastasis
Positron-Emission Tomography
Subtraction Technique
Ct technique
Female
Radiology
Tomography
Tomography, X-Ray Computed
business
Nuclear medicine
Subjects
Details
- ISSN :
- 16197089 and 16197070
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- European Journal of Nuclear Medicine and Molecular Imaging
- Accession number :
- edsair.doi.dedup.....9ebde6c6c06588afe4acefbd5f7a4f3a