The role of 18FDG PET/CT in the management of colorectal liver metastases

Engledow, Alec; Skipworth, James; Pakzad, Farrokh; Imber, Charles; Ell, Peter J.; Groves, Ashley M.

doi:10.1111/j.1477-2574.2011.00378.x

Cited by 22 publications

(20 citation statements)

References 37 publications

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“…The false negative rate was 2% and comparable with other contemporaneous studies. 15,16 A systematic review in 2005 by Weiring et al looked at 32 separate studies and showed FDG PET to have a higher sensitivity than CT for the detection of extrahepatic metastasis (91.5% vs 60.9%). 12 Most of the studies reviewed focused on the clinical impact or change in management due to the FDG PET, with change in 20-32% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Engledow et al looked at the use of the Fong clinical risk score 22 in the context of PET-CT in CLM. 16 They found that PET-CT changed management in 34% of patients and that there was a trend towards PET-CT being more influential in patients categorised as low risk by Fong criteria (44%) in comparison with the high risk patients (14%) although this failed to reach statistical significance. The study by Engledow et al raises the question of how patients might best be selected for PET-CT.…”

Section: A B Cmentioning

confidence: 98%

“…21 Our study and others demonstrate that in the majority of patients with CLM, PET-CT does not alter the extrahepatic imaging findings or management. 15,16 A number of predictive models exist that are designed to improve selection for liver surgery in patients with CLM. Engledow et al looked at the use of the Fong clinical risk score 22 in the context of PET-CT in CLM.…”

Section: A B Cmentioning

confidence: 99%

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The influence of FDG PET-CT on the detection of extrahepatic disease in patients being considered for resection of colorectal liver metastasis

Lake

Wadhwani

Subar

et al. 2014

annals

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East Lancashire Hospitals NHS Trust, UKABSTRACT INTRODUCTION The aim of this study was to evaluate the influence of flurodeoxyglucose positron emission tomography computed tomography (FDG PET-CT), as an adjunct to conventional CT staging, in the detection of extrahepatic disease in patients with potentially resectable colorectal liver metastasis. METHODS Overall, 133 consecutive patients with colorectal liver metastases staged with CT and PET-CT referred to the East Lancashire regional hepatobiliary multidisciplinary team over a two-year period were included in this study. Abnormal findings on PET-CT were correlated with follow-up imaging and/or histology. All imaging was reviewed by specialist hepatobiliary radiologists for the presence/absence of extrahepatic disease. The influence of the PET-CT findings was categorised for each patient in relation to operability and other significant findings. RESULTS PET-CT had a major impact on staging of extra hepatic disease in 20% of patients, in comparison with the initial CT. Six per cent of patients were upstaged from operable CT findings to inoperable findings on PET-CT because of the discovery of inoperable occult extrahepatic disease. Five per cent had operable local regional nodal disease detected on PET-CT. A further 3% had premalignant colorectal lesions detected on PET-CT. Six per cent of patients were downstaged from indeterminate or suspected inoperable CT findings to operable findings on PET-CT. CONCLUSIONS The use of PET-CT in this setting may prevent futile operations, guide the resection of local regional nodal disease and downstage a number of patients thought to have extrahepatic disease on conventional imaging. This study has shown similar results to other recent studies and supports the use of PET-CT as a necessary staging modality in patients with potentially resectable colorectal liver metastases.

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Section: Discussionmentioning

confidence: 99%

Section: A B Cmentioning

confidence: 98%

Section: A B Cmentioning

confidence: 99%

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The influence of FDG PET-CT on the detection of extrahepatic disease in patients being considered for resection of colorectal liver metastasis

Lake

Wadhwani

Subar

et al. 2014

annals

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“…Engledow et al [23] evaluated the yield of the FDG-PET in an attempt to stratify the use of the FDG-PET in patients with CRLM depending on CRS. The influence on management failed to reach statistical significance between low- and high-CRS patients.…”

Section: Discussionmentioning

confidence: 99%

“…The influence on management failed to reach statistical significance between low- and high-CRS patients. Based on this series, the Fong et al [10] CRS should not be used to rationalize the use of PET/CT in those patients being investigated for potential resection of CRLM [23]. Schüssler-Fiorenza et al [22] evaluated whether the CRS correlates with the yield of FDG-PET in patients with CRLM.…”

Section: Discussionmentioning

confidence: 99%

Preoperative FDG-PET-Scan in Patients with Resectable Colorectal Liver Metastases Does Not Improve Overall Survival: A Retrospective Analyses Stratified by Clinical Risk Score

Ayez

Ridder²,

Wiering³

et al. 2013

Dig Surg

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Background: The aim of this study was to determine whether selection with fluorine-18-deoxyglucose positron emission tomography (FDG-PET) imaging would result in an improved outcome in surgically treated patients with curative resection of colorectal liver metastases (CRLM), stratified by the clinical risk score (CRS) of Fong et al. [Ann Surg 1999;230:309-318]. Patients and Methods: Between January 2000 and December 2009, all patients who underwent resection for CRLM from two different university teaching hospitals in the Netherlands were analysed. Patients were stratified by the CRS. Results: In total 613 patients were eligible for analysis. There was no statistical difference in median disease-free survival (DFS) between patients with and without an FDG-PET scan in both low CRS [17 months (95% CI 12-22) vs. 14 months (95% CI 11-17), p = 0.332] and high CRS [14 months (95% CI 7-21) vs. 9 months (95% CI 8-10), p = 0.073]. There was no statistical difference in median overall survival (OS) between patients with and without an FDG-PET scan in both low CRS [64 months (95% CI 54-74) vs. 54 months (95% CI 42-66), p = 0.663] and high CRS [39 months (95% CI 23-55) vs. 41 months (95% CI 34-48), p = 0.903]. Conclusion: The present study could not demonstrate that patients selected by an FDG-PET scan before liver resection, and stratified by CRS, have an improvement in DFS or OS.

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Comparison of four MRI protocols for detection of extrahepatic colorectal cancer metastases

Sivesgaard

Jöhnk

Larsen

et al. 2017

Magnetic Resonance Imaging

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The role of 18FDG PET/CT in the management of colorectal liver metastases

Cited by 22 publications

References 37 publications

The influence of FDG PET-CT on the detection of extrahepatic disease in patients being considered for resection of colorectal liver metastasis

The influence of FDG PET-CT on the detection of extrahepatic disease in patients being considered for resection of colorectal liver metastasis

Preoperative FDG-PET-Scan in Patients with Resectable Colorectal Liver Metastases Does Not Improve Overall Survival: A Retrospective Analyses Stratified by Clinical Risk Score

Comparison of four MRI protocols for detection of extrahepatic colorectal cancer metastases

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