Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

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• 作者：Joen Sveistrup ; M.D.^&lowast ; ; ^{joensveistrup@hotmail.com} ; Annika Loft ; M.D. ; Ph.D.^&dagger ; ; Anne Kiil Berthelsen ; M.D.^&lowast ; ; ^&dagger ; ; Birthe Merete Henriksen ; M.D.^&Dagger ; ; Michael Bachmann Nielsen ; M.D. ; D.Sci^&Dagger ; ; Svend Aage Engelholm ; M.D. ; D.Sci.^&lowast ;
• 关键词：Anal cancer ; Staging ; PET/CT ; Transanal ultrasound (TAUS)
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2012
• 出版时间：1 May, 2012
• 年：2012
• 卷：83
• 期：1
• 页码：134-141
• 全文大小：165 K

文摘

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Purpose

This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed.

Methods and Materials

Ninety-five (95) patients referred to our clinic between July 1, 2005, and December 31, 2009, were retrospectively reviewed. All patients had biopsy-proven primary squamous cell cancer of the anal canal. There were 65 females (68 % ) and 30 males (32 % ), and the median age was 58 years (range, 35-88 years). Six (6 % ) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT.

Results

Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100 % ) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94 % ). Ten patients were diagnosed with suspicious inguinal nodes on PET/CT that had not been seen on US. One of these was malignant, three were benign, and six were not biopsied. PET/CT diagnosed eight metastatic sites, whereas TAUS/US diagnosed three. PET/CT discovered three of the five synchronous cancers seen in this study. PET/CT upstaged the disease in 14 % of the cases and changed the treatment plan proposed by TAUS/US in 17 % .

Conclusion

PET/CT has great potential influence on the staging and treatment of anal cancer. TAUS is important in the staging of the primary tumor and N1-stage, whereas PET/CT seems necessary for the N2/3-stage, the M-stage and synchronous cancers.