Tsuyoshi Morimoto MD, Presenter: Nothing to Disclose

Ukihide Tateishi MD, PhD, Abstract Co-Author: Nothing to Disclose

Tetsuo Maeda MD, Abstract Co-Author: Nothing to Disclose

Yasuaki Arai MD, Abstract Co-Author: Nothing to Disclose

Kazuro Sugimura MD, Abstract Co-Author: Nothing to Disclose

Yasuo Nakajima MD, Abstract Co-Author: Nothing to Disclose

Mototaka Miyake MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To determine the diagnostic accuracy of integrated contrast-enhanced computed tomography (CT) and positron emission tomography (PET), as compared with non-enhanced PET/CT, in preoperative nodal staging of rectal cancer.

Fifty-three patients (32 men and 21 women) with rectal cancer underwent staging with integrated CT and fluorine-18-fluorodeoxyglucose (F-18 FDG) PET/CT. Both non-enhanced PET/CT and contrast-enhanced PET/CT images were evaluated separately by two different qualified physicians for each imaging modality, and nodal staging was determined and correlated with histopathologic results. Patient-by-patient and lesion-by-lesion analyses were retrospectively performed. For nodal staging of rectal cancer, we compared diagnostic accuracy on patient-by-patient and lesion-by-lesion basis between two modalities using McNemar test, respectively.

Nodal staging was correctly determined with non-enhanced PET/CT in 37 patients (70%) and contrast-enhanced PET/CT in 42 patients (79%). On patient-by-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 PET/CT, while 85%, 42%, 73%, 62%, and 70%, respectively with non-enhanced PET/CT. Difference in the accuracy of nodal staging between non-enhanced PET/CT and contrast-enhanced PET/CT was significant (p<0.0001). Analysis on lesion-by-lesion, contrast-enhanced PET/CT determined more correctly the status of pararectal lymph node (p=0.002), internal iliac lymph node (p=0.004), and obturator lymph node (p<0.0001) compared with non-enhanced PET/CT.

Contrast-enhanced PET/CT improves the diagnostic accuracy of nodal staging in rectal cancer with higher specificity when compared with non-enhanced PET/CT.

Contrast-enhanced PET/CT improves the diagnostic accuracy of nodal staging in rectal cancer with higher specificity when compared with non-enhanced PET/CT.

Morimoto, T, Tateishi, U, Maeda, T, Arai, Y, Sugimura, K, Nakajima, Y, Miyake, M, et al, , et al, , Nodal Staging of Rectal Cancer with Contrast-enhanced Integrated PET/CT.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005585.html