Preoperative 18F-FDG PET/CT as a surgical triage tool for synchronous neoplasm detection in acute left-sided obstructive colorectal cancer: a two-institution retrospective cohort study - Summary - MDSpire

Utilizing Preoperative 18F-FDG PET/CT for Surgical Decision-Making in Identifying Synchronous Neoplasms in Acute Left-Sided Obstructive Colorectal Cancer: A Retrospective Study Across Two Institutions

  • By

  • Kyung Uk Jung

  • Sung Ryol Lee

  • Joosung Park

  • Hyung Ook Kim

  • Hungdai Kim

  • Hee-Sung Song

  • Ji Young Lee

  • Yong Bog Kim

  • Jaemin Jo

  • Ji Eun Park

  • Hyun Joo Song

  • Heung Up Kim

  • Weon Young Chang

  • Ho-kyung Chun

  • Donghyoun Lee

  • July 20, 2026

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Objective:

To evaluate the diagnostic performance of preoperative 18F-FDG PET/CT for synchronous neoplasm detection in patients with acute left-sided obstructive colorectal cancer.

Approach:
  • Method: Study Design
  • Method: Endpoints
  • Method: Reference Standard
Key Findings:
  • Invasive sCRC was confirmed in 9 patients (6.0%) and CSN in 17 patients (11.4%).
  • For invasive sCRC, PET/CT sensitivity was 77.8%, specificity 95.0%, PPV 50.0%, and NPV 98.5%.
  • For CSN, sensitivity was 52.9%, specificity 96.2%, PPV 64.3%, and NPV 94.1%.
  • Among 135 PET-negative patients, only 2 (1.5%) had invasive sCRC.
  • Secondary curative resection was required in 5 patients (3.4%) and therapeutic endoscopy in 8 (5.4%).
Interpretation:

Preoperative 18F-FDG PET/CT demonstrated a low rate of missed invasive synchronous cancer when negative (1.5%) and identified a subgroup requiring additional intraoperative assessment when positive.

Limitations:
  • Findings are exploratory and require prospective validation.
  • PET/CT is not a substitute for clearing colonoscopy and does not mandate extended resection.
Conclusion:

Preoperative 18F-FDG PET/CT can assist in identifying synchronous neoplasms in acute left-sided obstructive colorectal cancer but should not replace standard diagnostic procedures.

Original Source(s)

Preoperative 18F-FDG PET/CT as a surgical triage tool for synchronous neoplasm detection in acute left-sided obstructive colorectal cancer: a two-institution retrospective cohort study

  • by Kyung Uk Jung, Sung Ryol Lee, Joosung Park, Hyung Ook Kim, Hungdai Kim, Hee-Sung Song, Ji Young Lee, Yong Bog Kim, Jaemin Jo, Ji Eun Park, Hyun Joo Song, Heung Up Kim, Weon Young Chang, Ho-kyung Chun, Donghyoun Lee

  • July 20, 2026

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