Preoperative 18 F-FDG PET/CT as a surgical triage tool for synchronous neoplasm detection in acute…

Cohort studyFrontiers in surgery· 2026

Preoperative 18 F-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.

Kyung Uk Jung, Sung Ryol Lee, Joosung Park … Donghyoun Lee

Emergency Department FlowCohort studyDiagnosisQ2IF 1.8

PET-negative results rarely missed a second invasive colorectal cancer before surgery

Preoperative 18 F-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.

Kyung Uk Jung … Donghyoun Lee

Frontiers in surgery · 2026

Background

In acute left-sided obstructive colorectal cancer (obstructive colorectal cancer), the proximal colon cannot be evaluated endoscopically before surgery, and synchronous colorectal cancers (sCRC) and clinically significant neoplasms (clinically significant neoplasms) may remain undetected.

Methods

This retrospective cohort study included 149 consecutive patients with acute left-sided obstructive colorectal adenocarcinoma (splenic flexure through rectum) treated by primary curative resection at two tertiary centers (2007-2016).

n = 9 patients

Results

PET scans almost never missed a second cancer before surgery

77.8%

Sensitivity

95%

Specificity

More results

Median age was 69 years; 71.1% were male.

Invasive sCRC was confirmed in 9 patients (6.0%) and clinically significant neoplasms in 17 (11.4%).

For invasive sCRC, PET/CT showed sensitivity 77.8%, specificity 95.0%, PPV 50.0%, and NPV 98.5%.

More results

For clinically significant neoplasms, sensitivity was 52.9%, specificity 96.2%, PPV 64.3%, and NPV 94.1%.

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Conclusion · 1 of 2

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

Conclusion · 2 of 2

PET/CT is not a substitute for clearing colonoscopy and does not mandate extended resection. These findings are exploratory and require prospective validation.

Preoperative 18 F-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.

Preoperative 18 F-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.

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