0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Invited Critique: Whole-Body PET Imaging With [18F]Fluorodeoxyglucose in Management of Recurrent Colorectal Cancer

Steven D. Wexner, MD
Arch Surg. 1999;134(5):511-513. doi:10.1001/archsurg.134.5.511.
Text Size: A A A
Published online

Extract

Valk et al are certainly to be congratulated for their fervent enthusiasm for this new privately held technology. The skeptic might assume that since these private physicians are based in a PET imaging center, they would bias a study by design to favor PET scan; however, it is important to put aside all such potentially cynical prejudices in favor of academic interpretation of a large number of patients carefully assessed by a variety of means and numerous statistical tests. It is particularly important to do so in light of the scope of this problem. Colorectal cancer is the second most common noncutaneous malignant neoplasm, anticipated to affect approximately 165,000 people this year.1 It can also be anticipated that more than 40% of patients, despite seemingly curative resections, will experience a recurrence of their disease.24 The most common sites of recurrence are the pelvis, liver, and lungs. Over the past several decades, numerous new technologies have been introduced in an attempt to better identify and therefore more appropriately treat patients with recurrences in each of these areas. The primary tool for both preoperative and postoperative evaluation of patients with rectal carcinoma is rectal ultrasonography.57 The potential problem with rectal ultrasound is that whether the focal length is 5.0, 7.0, 7.5, or 10.0 MHz, the best clarity is in the layers of the rectal wall as opposed to within the pelvis itself. Local recurrences tend to occur not at the suture line or anastomosis but actually in the pelvis.8 Therefore, any intraluminal evidence of tumor tends to show the tip of the iceberg rather than the major nidus of tumor.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();