Abstract for presentation at 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 2008

Primary Staging of Rectal Cancer with PET/CT Scans

  • Dr Tim Eglington, Colorectal Surgical Unit, Royal Adelaide Hospital, Adelaide, Australia
  • Dr Dylan Bartholomeusz, Department Nuclear Medicine and P.E.T., Royal Adelaide Hospital, Adelaide, Australia
  • Dr D Neil Jones, Department of Medical Imaging, Flinders Medical Centre, Adelaide, Australia
  • Dr Andrew Hunter, Colorectal Surgical Unit, Royal Adelaide Hospital, Adelaide, Australia
  • Dr Andrew Luck, Colorectal Surgical Unit , Royal Adelaide Hospital, Adelaide, Australia
  • Dr Mathew Lawrence, Colorectal Surgical Unit , Royal Adelaide Hospital, Adelaide, Australia
  • Dr James Moore, Colorectal Surgical Unit , Royal Adelaide Hospital, Adelaide, Australia
  • A/Prof Barry Chatterton, Department Nuclear Medicine and P.E.T., Royal Adelaide Hospital, Adelaide, Australia

    • PET scans are important in staging recurrent colonic cancer. Combined PET /CT scanners enable PET and diagnostic CT imaging. We prospectively evaluated PET/CT scanning in the initial staging of 20 patients (14 male, mean age 63 (50-83) yrs with newly diagnosed rectal adenocarcinoma. Staging pelvic MRI, CT scans and PET/CT scans were performed in all patients and the results used to guide treatment. PET/CT scans were performed following 250MBq 18FDG on a Phillips Gemini 16 P scanner. In 14 patients a high dose CT scan after IV contrast of the neck, chest and abdomen was performed at the same time on the PET/CT scanner. In 6 patients who had recent diagnostic CT scans only a low dose CT was performed with the PET scan for tissue attenuation correction. Two specialists blinded to the results of the other investigation independently interpreted the PET and post contrast CT scans. The results were compared to the MRI and surgical results. PET identified the primary lesion in all cases. Twelve discordant findings were found between PET/CT and conventional imaging in 10 patients resulting in upstaging of 2 patients and down staging in 4 patients. The PET/CT identified non rectal cancer pathology in 4 patients including a synchronous colon cancer and prostate cancer. Non surgical treatment would have changed in 30% of cases based on the PET/CT result. These results indicate that combined PET/CT imaging is useful in the primary staging of rectal cancer.

    Conference Organiser - ICMS Pty Ltd