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Review
. 2008 Oct 4;8 Spec No A(Spec Iss A):S46-51.
doi: 10.1102/1470-7330.2008.9009.

PET/CT imaging in the diagnosis, staging, and follow-up of colorectal cancer

Raghu Vikram  1 , Revathy B Iyer
Affiliations
Review

PET/CT imaging in the diagnosis, staging, and follow-up of colorectal cancer

Raghu Vikram et al. Cancer Imaging. .

Abstract

Colorectal cancer is a common malignancy that afflicts many in the western world. Imaging studies are frequently used to evaluate patients in the screening, staging and surveillance of colorectal cancer. Cross sectional imaging studies such as ultrasound, computed tomography and magnetic resonance imaging provide anatomic and morphologic information about tumor and patterns of spread. Positron emission tomography (PET) differs in that it provides information about tumor metabolism.[(18)F]Fluorodeoxyglucose PET has been clinically used for the evaluation of patients with a wide variety of cancers since most malignancies, including colorectal cancer, typically show increased glucose metabolism. This review present the positron emission tomography/computed tomography imaging findings that may be encountered in the diagnosis, staging and follow-up of patients with colorectal cancer.

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Figures

Figure 1
Figure 1
Coronal MIP image (a) of an FDG-PET scan in a patient with a history of lymphoma who presented for routine surveillance shows focal uptake in the right lower quadrant (arrow) corresponding to a lesion in the cecum (arrow) on axial fused PET/CT (b) which proved to be a 3-cm adenomatous polyp at colonoscopy.
Figure 2
Figure 2
Coronal MIP PET image (a) of an FDG-PET scan shows a focal area of uptake in the descending colon (arrow). Corresponding axial CT (b) image shows diverticulosis and surrounding stranding (arrow) compatible with diverticulitis.
Figure 3
Figure 3
Coronal MIP PET image shows a primary FDG avid tumor in the rectosigmoid (thick arrow) with FDG avid metastases to the liver (thin arrows) in a patient with newly diagnosed colorectal cancer.
Figure 4
Figure 4
Fused PET/CT image (a) shows an FDG avid area along the left pelvic sidewall (arrow) with diffuse pre-sacral thickening without a distinct mass on contrast enhanced MRI (b) in a patient with colorectal cancer treated with chemoradiation and surgery, now with rising tumor markers. Biopsy of the FDG avid area proved recurrence.
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