Does positron emission tomography/computed tomography change management in colorectal cancer?

Abstract

PET/CT remains a useful adjunct to conventional imaging in the pre-operative workup of patients with colorectal cancer.

Does 18F-FDG PET/CT change the surgical management of potentially resectable colorectal liver metastases?

“…This result is in the lower range of the previously reported (2.7%–33.8%). 10 –20 Our results comply with a randomized trial performed in 2014 by Moulton et al 17 in which the addition of PET/CT changed management in 8% of the cohort. In their study, only 2.7% were excluded from surgery preventing exploratory laparotomy compared with 5.3% in our study.…”

“…Based on our findings, a quarter of the initial cohort was deemed unresectable on conventional CT and/or liver MRI, comparable with numbers presented in a study by Yip et al 27 Depending on study design, previous reports in the literature have suggested that preoperative PET/CT changes treatment strategy by up to 43% of patients with CLM deemed resectable on conventional imaging. [9][10][11][12][13][14][15][16][17][18][19][20] The majority have small or heterogeneous cohorts mixing both patients with known and suspected recurrent CRC located in the liver and lungs. Some studies have not specified if an MDT discussed the patients preoperatively.…”

“…Observational studies suggest a change in patient management of between 8% and 43%. [9][10][11][12][13][14][15][16][17][18][19][20] A recently published meta-analysis based on two randomized trials and 11 retrospective studies concluded that PET/CT changed the management of patients by between 8% and 20%. 21 In spite of this, the authors did not find any OS benefit from performing PET/CT, and there was no significant reduction in open-close surgery.…”