Prospective evaluation of the impact of [18F]fluoro-2-deoxy-<scp>d</scp>-glucose positron emission tomography of resectable colorectal liver metastases

Truant, Stéphanie; Huglo, D.; Hebbar, Mohamed; Ernst, Olivier; Steinling, M.; Pruvot, F.-R.

doi:10.1002/bjs.4843

Cited by 109 publications

(78 citation statements)

References 37 publications

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“…CT has previously been established as a way to evaluate response to chemotherapy treatment in solid tumors as defined by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria [25]. FDG-PET, due to its superior sensitivity in detecting extrahepatic disease, is extremely useful in reducing the number of futile operative procedures performed in patients with otherwise occult metastatic disease [26][27][28][29]. The utility of this preoperative study was also shown by Strasberg et al [30] to lessen tumor recurrence in a chemo-naïve patient cohort undergoing hepatic resection for colorectal metastases.…”

Section: Discussionmentioning

confidence: 99%

Response to chemotherapy predicts survival following resection of hepatic colo‐rectal metastases in patients treated with neoadjuvant therapy

Small¹,

Lubezky²,

Shmueli³

et al. 2008

Journal of Surgical Oncology

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Background: Prognosis of patients following resection of CRC metastases to the liver has traditionally been predicted by clinical risk factors. In the era of neoadjuvant chemotherapy, determination of new prognostic indicators of outcome are necessary. Methods: This retrospective study includes patients with CRC liver metastases, who received oxaliplatin or irinotecan based neoadjuvant chemotherapy and underwent R0 resection. Patients were followed by CT and PET-CT, before, during and after chemotherapy and surgery. The predictive value of the Memorial Sloan-Kettering Cancer Center Clinical Score (MSKCC-CS) and degree of response to chemotherapy (measured by CT and PET-CT), were analyzed by univariate and multivariate COX regression. Results: Included are 54 patients. Overall 1-, 2-, 3-year survival rates 88%, 70%, and 39%. Response to chemotherapy on CT was a significant predictor of survival on univariate (P ¼ 0.03) and multivariate analysis (P ¼ 0.03), whereas MSKCC-CS and response to chemotherapy on PET-CT were not. Multivariate analysis demonstrated response to chemotherapy as a predictor of time to recurrence on CT (P ¼ 0.02) and PET-CT (P ¼ 0.03), while the MSKCC-CS (P ¼ 0.64) was not. Conclusions: In this cohort of patients treated by neoadjuvant chemotherapy, the outcome was not predicted by the traditional clinical scoring system, but rather by response to chemotherapy as evaluated by CT and PET-CT.

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Section: Discussionmentioning

confidence: 99%

Response to chemotherapy predicts survival following resection of hepatic colo‐rectal metastases in patients treated with neoadjuvant therapy

Small¹,

Lubezky²,

Shmueli³

et al. 2008

Journal of Surgical Oncology

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“…18 Fluorodeoxyglucose positron emission tomography (FDG-PET) detects changes in glucose uptake and metabolism, and also provides information about the location of a cancer within tissues. It is now considered to be a sensitive and accurate technique, and several studies have suggested that it should be carried out before resection of liver metastases from CRC van der Hiel et al, 2001;Fernandez et al, 2004;Truant et al, 2005;Wiering et al, 2005;Khan et al, 2006).…”

mentioning

confidence: 99%

Early detection of recurrence by 18FDG-PET in the follow-up of patients with colorectal cancer

et al. 2008

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We assessed the potential benefits of including systematic 18 fluorodeoxyglucose positron emission tomography (FDG-PET) for detecting tumour recurrence in a prospective randomised trial. Patients (N ¼ 130) who had undergone curative therapy were randomised to undergo either conventional (Con) or FDG-PET procedures during follow-up. The two groups were matched at baseline. Recurrence was confirmed histologically. 'Intention-to-treat' analysis revealed a recurrence in 46 patients (25 in the FDG-PET group, and 21 in the Con group; P ¼ 0.50), whereas per protocol analysis revealed a recurrence in 44 out of 125 patients (23 and 21, respectively; P ¼ 0.60). In another three cases, PET revealed unexpected tumours (one gastric GIST, two primary pulmonary cancers). Three false-positive cases of FDG-PET led to no beneficial procedures (two laparoscopies and one liver MRI that were normal). We failed to identify peritoneal carcinomatosis in two of the patients undergoing FDG-PET. The overall time in detecting a recurrence from the baseline was not significantly different in the two groups. However, recurrences were detected after a shorter time (12.1 vs 15.4 months; P ¼ 0.01) in the PET group, in which recurrences were also more frequently (10 vs two patients) cured by surgery (R0). Regular FDG-PET monitoring in the follow up of colorectal cancer patients may permit the earlier detection of recurrence, and influence therapy strategies.

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“…Compared to CT, PET is superior for the detection of extrahepatic metastases [29,32]. In a prospective trial, PET sensitivity was equivalent to CT for detection of hepatic metastasis but was superior for extrahepatic sites (63 vs. 25 %) [32]. In this study, PET identified 5 additional patients with extrahepatic disease but also falsely upstaged 3 patients out of a total of 59 [32].…”

Section: Positron Emission Tomographymentioning

confidence: 58%

Section: Positron Emission Tomographymentioning

confidence: 96%

“…In a prospective trial, PET sensitivity was equivalent to CT for detection of hepatic metastasis but was superior for extrahepatic sites (63 vs. 25 %) [32]. In this study, PET identified 5 additional patients with extrahepatic disease but also falsely upstaged 3 patients out of a total of 59 [32]. Due to PET's relatively high sensitivity, specificity and ability to identify extrahepatic disease, PET imaging results in clinically significant findings that lead to changes in management in 9-32 % of patients with CRC [31][32][33].…”

Section: Positron Emission Tomographymentioning

confidence: 97%

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Preoperative Imaging in Colorectal Liver Metastases: Current Practices

2013

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Surgical resection offers the only treatment associated with long-term survival for colorectal cancer (CRC) with hepatic metastasis. Imaging studies are paramount for the identification of potential surgical candidates. Synchronous hepatic disease is identified at presentation in 20-30 % of patients and ultimately, hepatic metastases occur in over 50 % of patients diagnosed with CRC. Computed tomography (CT) has been the imaging standard to identify patients with hepatic metastasis, but the array of preoperative imaging has expanded over the past several years. Currently, ultrasound, CT, magnetic resonance imaging, and positron emission tomography all play a vital role in the management and treatment of stage IV CRC. In addition, patient characteristics such as steatosis and treatment such as neoadjuvant chemotherapy affect imaging of hepatic metastases. The goal of this review is to discuss the current standing of imaging modalities used in the perioperative care of patients with colorectal liver metastasis.

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Prospective evaluation of the impact of [18F]fluoro-2-deoxy-d-glucose positron emission tomography of resectable colorectal liver metastases

Abstract: Whole-body FDG-PET may identify unrecognized extrahepatic metastases in patients with potentially resectable liver metastases imaged by CT. However, additional information provided by PET is not as reliable as suggested by earlier retrospective studies.

Cited by 109 publications

References 37 publications

Response to chemotherapy predicts survival following resection of hepatic colo‐rectal metastases in patients treated with neoadjuvant therapy

Response to chemotherapy predicts survival following resection of hepatic colo‐rectal metastases in patients treated with neoadjuvant therapy

Early detection of recurrence by 18FDG-PET in the follow-up of patients with colorectal cancer

Preoperative Imaging in Colorectal Liver Metastases: Current Practices

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