FDG PET/CT in the Management of Colorectal and Anal Cancers

Agarwal, Ankit; Marcus, Charles; Xiao, Jennifer; Nene, Prachi; Kachnic, Lisa A.; Subramaniam, Rathan M.

doi:10.2214/ajr.13.12256

Cited by 64 publications

(31 citation statements)

References 84 publications

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“…Treatment with chemotherapy causes a reduction of SUV within the tumor or metastases often before morphological changes become visible. This can be used for treatment or response monitoring [78]. Furthermore, several reports indicate that SUVmax or reduction of SUV after treatment can be used as prognostic factors for tumor recurrence or overall survival [78,79].…”

Section: Ultrasonographymentioning

confidence: 99%

“…Furthermore, several reports indicate that SUVmax or reduction of SUV after treatment can be used as prognostic factors for tumor recurrence or overall survival [78,79]. PET/CT has also the potential to improve radiation therapy by optimization of the planning target volumes and subsequently radiation dose [78].…”

Section: Ultrasonographymentioning

confidence: 99%

“…In the case of metastatic colorectal cancer, PET/CT can provide additional information and change treatment strategy for some patients [77,78]. Prior to liver resection for CRLM, PET/CT is used to rule out extrahepatic disease, which might preclude liver resection and change the therapeutic approach from a potential curative to a palliative treatment.…”

Section: Ultrasonographymentioning

confidence: 99%

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Impact of Contrast-Enhanced Intraoperative Ultrasound on Operation Strategy in Case of Colorectal Liver Metastasis

et al. 2012

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Background Surgical treatment is the only option for long-term survival in patients with colorectal liver metastasis (CRLM). Contrast-enhanced CT and MRI are usually used for preoperative liver imaging. The initial surgical strategy for liver resection is based upon these findings. Further optimization of the surgical strategy by contrast-enhanced intraoperative ultrasound (CE-IOUS) might further improve the surgical outcome. Purpose To evaluate the current impact of CE-IOUS with SonoVue® on the initial surgical strategy for CRLM. Material and Methods Eighty-six consecutive patients undergoing open liver resection for CRLM were evaluated retrospectively over a 2.5-year period. The patients underwent 97 operations. Preoperative staging was performed with contrast-enhanced CT in all patients and MRI was available in 66 of 86 patients. CE-IOUS was performed in all patients according to a standardized examination technique. Curved array and linear transducers were used. CRLM were identified in venous phase as hypovascular lesions. CE-IOUS findings were compared with preoperative staging. Results Combined CT/MRI identified preoperatively 328 CRLM (mean 3.4, range 0-14). Seventy-two additional lesions (18%) were identified in 38 patients during the operation. Intraoperatively 41 additional CRLM in 20 patients were identified by inspection, palpation, and CE-IOUS (10%), and another 31 CRLM in 17 patients were identified by CE-IOUS alone (8%). All additional CRLM detected by CE-IOUS were confirmed by histology if resection was performed. CE-IOUS changed planned operation strategy in 29.9% of operations. A larger resection was necessary in 13.4% of the cases, reduced liver resection was found sufficient in 11.3%, and 5.2% were found inoperable. For patients diagnosed preoperatively with solitary lesions CE-IOUS changed operation strategy in 19% and radical tumor resection would have failed in 4.8% without CE-IOUS. Conclusion CE-IOUS is essential to ensure optimal and complete tumor resection both in patient with solitary CRLM and multiple metastases.

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Section: Ultrasonographymentioning

confidence: 99%

Section: Ultrasonographymentioning

confidence: 99%

Section: Ultrasonographymentioning

confidence: 99%

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Impact of Contrast-Enhanced Intraoperative Ultrasound on Operation Strategy in Case of Colorectal Liver Metastasis

et al. 2012

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“…PET/CT is currently recommended by the American College of Radiology for staging of large rectal cancers because results of studies have shown that use of this modality may accurately change the staging or influence treatment planning for this subset of patients (34,39). Results of several metaanalyses have shown PET/CT to be superior to CT for use in detection of hepatic metastases (40,41). One scenario in particular that may be amenable to PET/CT evaluation is exclusion of occult metastases in patients being considered for liver metastectomy with curative intent (26).…”

Section: Initial Assessment Rectal Cancermentioning

confidence: 99%

“…In a small study of 34 patients with T3-T4, N0-N1, and M0-M1 disease, Whaley et al (44) found that PET/CT altered staging in 18% of patients and improved interobserver concordance in contouring boost treatment volumes compared with CT alone. This may be due to the superior ability of PET/ CT to delineate tumor volume, which serves to minimize treatment margins and exclude nondiseased tissue (40).…”

Section: Initial Assessment Rectal Cancermentioning

confidence: 99%