Impact of 18F-FDG-PET in decision making for liver metastectomy of colorectal cancer

Background:  The ability of 18F‐fluorodeoxyglucose positron emission tomography (FDG‐PET) to impact on management of patients with recurrent colorectal cancer is high. However, direct impact of FDG‐PET on surgical management of patients with potentially resectable hepatic metastases is limited. Meth...

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Bibliographic Details
Published in:ANZ journal of surgery 2012-01, Vol.82 (1-2), p.30-35
Main Authors: McLeish, Andrew R., Lee, Sze Ting, Byrne, Amanda J., Scott, Andrew M.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Colorectal cancer
Colorectal Neoplasms - pathology
Decision making
Decision Support Techniques
FDG-PET
Female
Fluorodeoxyglucose F18
Hepatectomy
Humans
Liver
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Male
management
Metastasis
metastatic colorectal cancer
Middle Aged
Patient Care Planning
Positron-Emission Tomography
Radiopharmaceuticals
Retrospective Studies
Surgery
Tomography
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Summary:Background:  The ability of 18F‐fluorodeoxyglucose positron emission tomography (FDG‐PET) to impact on management of patients with recurrent colorectal cancer is high. However, direct impact of FDG‐PET on surgical management of patients with potentially resectable hepatic metastases is limited. Methods:  FDG‐PET scans of patients with colorectal cancer at Austin Hospital in a 2‐year period were retrospectively evaluated. Data were collected on patient demographics, scan indication and sites of disease pre‐ and post‐PET. Results of standard imaging tests and FDG‐PET scans were analysed. The potential impact of FDG‐PET on proposed surgical management plans was assessed by an experienced surgeon. Results:  There were 585 FDG‐PET scans performed on 470 patients (309M : 161F, mean age 61.9 years) with colorectal cancer. Hepatic metastases were identified on standard imaging in 232 (39.7%) patients, and FDG‐PET confirmed hepatic metastasis in 203 cases, including 22 cases with new lesions, and clarified presence of disease in 34/37 (92%) cases with equivocal standard imaging. In 54 patients, FDG‐PET was performed for disease assessment before hepatic resection. FDG‐PET had substantial management plan impact in 36/54 (66.7%) patients. Conclusions:  FDG‐PET can profoundly impact on the management plan of patients with colorectal cancer who may be suitable for hepatic metastectomy.
ISSN:1445-1433
1445-2197
DOI:10.1111/j.1445-2197.2010.05601.x