Accuracy of PET/CT for the Detection of Synchronous Malignant Lesions in Patients With Endoscopically Obstructive Colorectal Cancer.

IF 1.3 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2026-10-01 DOI:10.1097/SLE.0000000000001484

Cemil Burak Kulle, Mehmet Iskender Yıldırım, Halil Alper Bozkurt, Emine Göknur Işık, Melek Büyük, Neslihan Berker, İlker Özgür, Mehmet Türker Bulut, Metin Keskin, Adem Bayraktar

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引用次数: 0

Abstract

Background: This study aimed to assess the diagnostic performance of positron emission tomography/computed tomography (PET/CT) in detecting synchronous malignant lesions in the proximal colon in endoscopically obstructive left-sided colorectal cancer.

Materials and methods: All patients with a biopsy-proven left-sided endoscopically obstructive colorectal cancer who had a preoperative PET/CT scan and a postoperative total colonoscopy within 6 months after the index surgery between January 2015 and July 2024 at a comprehensive cancer center were enrolled into the study. The synchronous malignant lesions on PET/CT were confirmed with the pathologic examination of the subtotal/total colectomy specimen and postoperative total colonoscopy. The primary endpoint was to evaluate the diagnostic performance of PET/CT in detecting synchronous malignant lesions, and the second endpoint was to determine the ability of PET/CT to distinguish malignant lesions from advanced adenomas.

Results: Out of 90 patients, 50 (55.6%) were male with a mean age of 62.46±10.81 years. The obstructing malignant lesions detected on colonoscopy were located in the rectum, n=8 (8.9%), rectosigmoid junction, n=29 (32.2%), sigmoid colon, n=31 (34.4%), descending colon, n=16 (17.8%), and distal part of the transverse colon, n=6 (6.7%). Nine areas of abnormal fluorodeoxyglucose (FDG) uptake on PET/CT in the proximal part of the colon with a mean SUVmax value of 19.23 (range: 6.4-42) were identified in 6 patients. Four patients with synchronous lesions on PET/CT underwent a total colectomy. Two patients with synchronous lesions on PET/CT were treated with segmental resection with subsequent postoperative endoscopic submucosal dissection (ESD) for the synchronous lesion. The detection rate of PET/CT for synchronous malignant lesions was 4.4% (n=4) with a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 100%, 94.4%, 44.4%, 100%, and 94.6%, respectively.

Conclusions: PET/CT demonstrated a high sensitivity and a high negative predictive value in detecting synchronous malignant lesions located in the proximal colon distal to the obstructing left-sided colorectal cancer. As a result, patients underwent a single-stage surgery and were spared from an unnecessary second surgical intervention.

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PET/CT对内镜下梗阻性结直肠癌同步恶性病变检测的准确性。

背景：本研究旨在评估正电子发射断层扫描/计算机断层扫描（PET/CT）对内镜下梗阻性左侧结直肠癌近端结肠同步恶性病变的诊断价值。材料与方法：所有2015年1月至2024年7月在某综合性癌症中心行活检证实的左侧内镜下梗阻性结直肠癌患者，术前行PET/CT扫描，术后6个月内行全结肠镜检查。经结肠次全切除/全切除标本病理检查及术后全结肠镜检查，证实PET/CT同步恶性病变。主要目的是评价PET/CT对同步恶性病变的诊断性能，第二个目的是确定PET/CT对恶性病变与晚期腺瘤的区分能力。结果：90例患者中，男性50例（55.6%），平均年龄62.46±10.81岁。结肠镜检出梗阻性恶性病变位于直肠8例（8.9%）、直肠乙状结肠结29例（32.2%）、乙状结肠31例（34.4%）、降结肠16例（17.8%）、横结肠远端6例（6.7%）。6例患者在PET/CT上发现结肠近端氟脱氧葡萄糖（FDG）摄取异常9个区域，平均SUVmax值为19.23（范围：6.4-42）。4例PET/CT同步病变患者行全结肠切除术。2例PET/CT同步病变患者行节段性切除并术后内镜下粘膜下剥离术（ESD）。PET/CT对同步恶性病变的检出率为4.4% (n=4)，其敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、准确率分别为100%、94.4%、44.4%、100%、94.6%。结论：PET/CT对位于阻塞性左侧结直肠癌远端结肠近端同步恶性病变具有较高的敏感性和阴性预测值。结果，患者接受了一期手术，免去了不必要的第二次手术干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.