Effect of chemotherapy on the impact of FDG-PET/CT in selection of patients for surgical resection of colorectal liver metastases: single center analysis of PET-CAM randomized trial

The largest randomized controlled trial (RCT) on the effect of FDG-PET on surgical management for metastatic colorectal adenocarcinoma to liver (“PET-CAM”) reported only a modest change in surgical management (8%). Purpose To explore the relationship between prior chemotherapy and detection of metas...

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Bibliographic Details
Published in:Annals of nuclear medicine 2017-02, Vol.31 (2), p.153-162
Main Authors: Metser, Ur, Halankar, Jaydeep, Langer, Deanna, Mohan, Ravi, Hussey, Douglas, Hadas, Moshonov, Tamir, Shlomit
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnostic imaging
Adenocarcinoma - drug therapy
Adenocarcinoma - secondary
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Antineoplastic Agents
Colorectal Neoplasms - drug therapy
Colorectal Neoplasms - pathology
Combined Modality Therapy - methods
Female
Fluorodeoxyglucose F18
Humans
Imaging
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - drug therapy
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Nuclear Medicine
Original Article
Positron Emission Tomography Computed Tomography - methods
Radiology
Radiopharmaceuticals
Retrospective Studies
Sensitivity and Specificity
Young Adult
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Summary:The largest randomized controlled trial (RCT) on the effect of FDG-PET on surgical management for metastatic colorectal adenocarcinoma to liver (“PET-CAM”) reported only a modest change in surgical management (8%). Purpose To explore the relationship between prior chemotherapy and detection of metastatic disease on PET in patients from PET-CAM. Secondary aim: to determine whether centralized imaging interpretation could have impacted trial results. Methods The study included 120 patients from a single institution. Local PET interpretation (PET-L) was recorded from the original database. Retrospective PET interpretation was performed independently by at least one additional reader (PET-C). The presence of extrahepatic disease (EHD) and significant additional liver metastases (=SALM), defined as metastases not originally planned for resection, was recorded. Patients were stratified to responders to recent chemotherapy (Group R) versus all others (Group O) according to surgical pathology and RECIST criteria. Results Thirty-seven of 50 patients who received recent chemotherapy (
ISSN:0914-7187
1864-6433
DOI:10.1007/s12149-016-1139-y