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To compare the effectiveness of Positron-Emission Tomography/Computed Tomography (PET/CT) with the Computed Tomography (CT) in the initial staging ofprimary rectal cancer.Thirty-eight patients (mean age 61.6 years, 26 male) withprimary adenocarcinoma of rectum were assessed with both PET/CT and conventional staging methods (chest, abdomen and pelvis CT, dynamic liver CT). Data from the conventional imaging methods and PET/CT was recorded and the patients were treated with an appropriate method to the stage of disease.Comparing PET/CT with conventional imaging modalities there were additional findings in seven patients (18.4%). PET/CT findings resulted in a change in the clinical stage (upstaged) in six patients (15.8%) and therapy plan was also changed in those patients. Tumours were located within 6 cm from the anal verge in five out of those six patients. In only one patient (2.6%) the therapy plan has not changed in light of the new findings on PET/CT. PET/CT did not showprimary tumour in two patients (5.3%).PET/CTprovides additional findings to conventional CT staging ofprimary rectal cancer, especially in distal cancer. These findings may affect treatment strategies of rectal cancer patients.