Little evidence supports use of PET/CT in staging colorectal cancer

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There is little evidence to support the use of PET/CT imaging in the pre-operative staging of primary colorectal cancer, according to research published in the October edition of Health Technology Assessment.

The research was funded by the National Institute for Health Research Health Technology Assessment (NIHRHTA) program and led by Professor David Weller of the University of Edinburgh. Researchers reviewed existing evidence and conducted database searches, reference list searches and contacted experts to determine the diagnostic accuracy and therapeutic impact of CT in combination with PET/CT (FDG PET/CT) scanning.

Weller and colleagues found limited evidence to support the use of FDG PET/CT in the pre-operative staging of primary, recurrent and spreading colorectal cancer. FDG PET/CT was shown to change patient management, but the data were divergent and the quality of research studied was generally poor. There were inconsistent findings about the effect of FDG PET/CT surgical management and it was found that the published research did not reflect routine clinical practice in the U.K.

“None of the economic models reported cost savings, but the approach adopted was conservative in order to determine more reliable results given the lack of current information,” wrote the authors. “FDG PET/CT as an add-on imaging device is cost-effective in the pre-operative staging of recurrent colon, recurrent rectal and metastatic disease but not primary colon or rectal cancers.”

Because of the uncertainty about the value of using FDG PET/CT in the treatment of bowel colorectal cancer, researchers called on physicians to continue to examine the results of the procedure.

“Importantly, practitioners who access this imaging technology need to routinely collect data to enable audits of patient outcomes, including detection rate and any changes in management resulting from its use,” Weller said in a statement.