FDG-PET is indicated as the initial test for diagnosis and staging of recurrence, for preoperative staging (N and M) of known recurrence, for the differentiation of benign from malignant lesions (indeterminate lymph nodes, hepatic and pulmonary lesions), for the differentiation of posttreatment changes from recurrent tumor, for the evaluation of patients with rising tumor markers in the absence of a known source, for a subgroup of patients at high risk (elevated CEA levels), for patients with a normal CT in whom surgery could be avoided if FDG-PET shows metastases, and for screening for recurrence in patients at high risk. It also affects the clinical management by guiding further procedures (biopsy, surgery, and radiation therapy) and excluding the need for additional procedures.

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