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

Authors


  • A. R. McLeish FRACS; S. T. Lee FRACP; A. J. Byrne MSc; A. M. Scott FRACP.

  • This study was supported in part by NH&MRC Program Grant no. 280912 and 487922.

  • This paper is not based on previous communication to a society or at a previous meeting.

Professor Andrew M. Scott, Centre for PET, Austin Hospital, Studley Road, Heidelberg, Vic. 3084, Australia. Email: andrew.scott@ludwig.edu.au

Abstract

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.

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