Abstract
Objective To explore the diagnostic value of delayed 18F-FDG PET/CT pelvic imaging after forced diuresis in detecting male patients with locally recurrent rectal cancer. Methods Thirty-two male patients (32-79 years) with clinically suspicious recurrences of rectal cancer were retrospectively analyzed. All patients underwent a standard 18F-FDG PET/CT followed by a delayed pelvic imaging after 2.5 h of administration of 20 mg furosemide intravenously and extra water intake of 500 ml at least. Final diagnosis was made by pathology or clinical follow-up (>10 months). Diagnostic efficiency of 18F-FDG PET/CT standard and delayed pelvic images were calculated and compared. χ2 test was used for data analysis. Results A total of 25 patients were diagnosed with recurrent rectal cancer, including 10 cases with invasion of surrounding tissue, and 5 cases with metastases. Among the 7 patients without local recurrences, 2 had distant metastases. The sensitivity, specificity, and accuracy of standard FDG PET/CT were 92.0%(23/25), 3/7, 81.2%(26/32), respectively. The corresponding values of the delayed imaging were 96.0%(24/25), 6/7, and 93.8%(30/32), respectively. The specificity of delayed imaging was higher than that of standard FDG PET/CT (χ2=14.333, P 0.05). The urinary bladder activity reached or approached the background during the delayed imaging. Twenty-two malignant lesions of surrounding invasion were confirmed. The positive rate of delayed imaging was higher than that of standard FDG PET/CT: 95.5%(21/22) vs 63.6%(14/22); χ2=6.400, P<0.05. Conclusions 18F-FDG PET/CT delayed pelvic imaging after diuresis and hydration is useful for eliminating the artifacts from urinary bladder activity, and for detecting the invasion to the rectal surrounding tissue more effectively. It could be a supplement to standard FDG PET/CT. Key words: Rectal Neoplasms; Neoplasm recurrence, local; Diuresis; Tomography, emission-computed; Tomography, X-ray computed; Deoxyglucose
Published Version
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