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Whole-body scans may provide option for diagnosing colorectal cancer

y PET/CT colonography in 37 (74 percent) of 50 lesions and by CT alone in 26 (52 percent) of 50 lesions at a certain threshold of measurement. With CT + PET, TNM was correctly determined in 32 (64 percent) of 50 lesions. Compared with optimized abdominal CT staging alone, PET/CT colonography was more accurate in defining TNM stage (difference, 22 percent), which was mainly based on a more accurate definition of the T-stage.

Of the 47 patients, PET/CT colonography changed the therapy management in 4 (9 percent) compared with conventional staging. The change in patient management was based either on a more accurate assessment of the tumor stage of colorectal cancer or on accompanying findings on PET/CT colonography.

"In addition to optical colonoscopy, whole-body PET/CT colonography as an all-in-one staging modality seems feasible to provide an alternative to the multimodality, multistep staging in patients with colorectal cancer. It is less time-consuming than a conventional multistep approach with CT alone (abdomen and thorax) and PET imaging if required. Thus, it represents a psychological and physical advantage when considering the burden to the patient of different imaging procedures. The referring physician will receive a single report including complete tumor staging in a single step, enabling him/her to define further therapy," the authors write.

"This preliminary report suggests that PET/CT colonography may be at least equivalent to CT + PET with respect to tumor staging in patients with colorectal cancer. The reason for a change in patient management with PET/CT colonography compared with a conventional staging concept must be attributed partially to the detection of synchronous [existing at the same time] tumors rather than to a more accurate TNM staging of colorectal cancer. Because an all-in-one staging modality has to offer both accurate TNM staging of the tumor in question and information on potentially present s
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Contact: Gerald Antoch
gerald.antoch@uni-duisburg-essen.de
JAMA and Archives Journals
5-Dec-2006


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