Imaging strategies in hepatic metastases from colorectal carcinoma

Abstract

Abstract:Approximately two-thirds of metastatic lesions that develop following curative resection of colorectal cancer occur in the liver and lung. In select groups of patients, resection of these lesions is associated with increased 5-year survival. In the liver, precise preoperative documentation of the presence, location, number, and relationship of these lesions to vascular structure is crucial in the selection of candidates for curative resection. Computed tomography with arterial portography (CTAP), intraoperative ultrasonography (IOUS), positron emission tomographic (PET) scan, and radionuclide scanning, including radiolabeled monoclonal antibody imaging, are emerging as the procedures of choice in the preoperative and intraoperative evaluation of metastatic c01orectal cancer to the liver.

Do the newer imaging modalities affect management of solid tumors?

“…The technique of radioimmunoscintigraphy has been effectively employed to aid oncologic decision-making in colorectal cancer. When liver resection is being contemplated for solitary metastasis, the MAb scan is utilized to rule out extrahepatic, extra-abdominal, or locoregional recurrence before surgery is undertaken [9]. Similarly, when pelvic or other locoregional recurrence is identified, the immunoscintigraphy (IS) is obtained to confirm the recurrence and rule out synchronous parenchymal (liver, lung, adrenal, brain) or bone metastasis.…”