Preoperative imaging for colorectal liver metastases: a nationwide population-based study

Abstract

Background: In patients with colorectal liver metastases (CRLM) preoperative imaging may include contrast-enhanced (ce) MRI and [ 18 F]fluorodeoxyglucose (18 F-FDG) PET-CT. This study assessed trends and variation between hospitals and oncological networks in the use of preoperative imaging in the Netherlands. Methods: Data for all patients who underwent liver resection for CRLM in the Netherlands between 2014 and 2018 were retrieved from a nationwide auditing database. Multivariable logistic regression analysis was used to assess use of ceMRI, 18 F-FDG PET-CT and combined ceMRI and 18 F-FDG PET-CT, and trends in preoperative imaging and hospital and oncological network variation. Results: A total of 4510 patients were included, of whom 1562 had ceMRI, 872 had 18 F-FDG PET-CT, and 1293 had combined ceMRI and 18 F-FDG PET-CT. Use of ceMRI increased over time (from 9⋅6 to 26⋅2 per cent; P < 0⋅001), use of 18 F-FDG PET-CT decreased (from 28⋅6 to 6⋅0 per cent; P < 0⋅001), and use of both ceMRI and 18 F-FDG PET-CT 16⋅9 per cent) remained stable. Unadjusted variation in the use of ceMRI, 18 F-FDG PET-CT, and combined ceMRI and 18 F-FDG PET-CT ranged from 5⋅6 to 100 per cent between hospitals. After case-mix correction, hospital and oncological network variation was found for all imaging modalities. Discussion: Significant variation exists concerning the use of preoperative imaging for CRLM between hospitals and oncological networks in the Netherlands. The use of MRI is increasing, whereas that of 18 F-FDG PET-CT is decreasing. Funding information No funding * Members of the Dutch Hepato-Biliary Audit Group are co-authors and can be found under the heading Collaborators.

Short-term postoperative outcomes after liver resection in the elderly patient: a nationwide population-based study

“…2 No ethical approval was needed under Dutch law as the DHBA is part of the Dutch Inspectorate of health care and the dataset is anonymized as described in earlier studies with data from the DHBA. 3,13,14 Patient selection All patients who underwent liver resection for primary and secondary liver tumours between the 1st of January 2014 and the 31st of December 2019 in the Netherlands were included if they were registered in the DHBA before the 22nd of March 2020. Patients were excluded if no date of birth, date of surgery or type of tumour could be obtained.…”

Fluorescence-guided surgery in colorectal cancer; A review on clinical results and future perspectives

“…With minimal invasive surgery this has become challenging. Nowadays, preoperative magnetic resonance imaging (MRI), computed tomography (CT) and intraoperative ultrasound (IOUS) are the most frequently used imaging modalities for the identification of CRLM [53]. Fluorescence imaging offers surgeons another tool for detecting CRLM.…”

Hospital variation in combined liver resection and thermal ablation for colorectal liver metastases and impact on short-term postoperative outcomes: a nationwide population-based study

“…Seven oncological networks were classified according to treatment collaboration between hospitals or topographical location if no collaboration network was present, as described earlier. 14,15 Oncological, networks include one or two tertiary referral centers and several regional hospitals performing liver surgery. Regional centers can refer patients to tertiary referral centers if the patient or tumor requires specific tertiary care.…”