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Value of Positron Emission Tomography With [F-18]Fluorodeoxyglucose in Patients With Colorectal Liver Metastases: A Prospective Study
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Titel: |
Value of Positron Emission Tomography With [F-18]Fluorodeoxyglucose in Patients With Colorectal Liver Metastases: A Prospective Study |
In: | Journal of Clinical Oncology, 20, 2002, 2, S. 388-395 |
veröffentlicht: |
American Society of Clinical Oncology (ASCO)
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Umfang: | 388-395 |
ISSN: |
0732-183X 1527-7755 |
DOI: | 10.1200/jco.2002.20.2.388 |
Zusammenfassung: | <jats:p> PURPOSE: To assess prospectively the value of fluor-18-deoxyglucose (FDG) positron emission tomography (PET), in addition to conventional diagnostic methods (CDM), as a staging modality in candidates for resection of colorectal liver metastases. </jats:p><jats:p> PATIENTS AND METHODS: In 51 patients analyzed for resection of colorectal liver metastases, clinical management decisions were recorded after a complete work-up with CDM. Afterward, FDG-PET scans were performed and any change of clinical management according to FDG-PET results was carefully documented. Discordances between FDG-PET and CDM results were identified and related to the final diagnosis by histopathology, intraoperative findings, and follow-up. </jats:p><jats:p> RESULTS: In 10 (20%) out of 51 patients, clinical management decisions based on CDM were changed after FDG-PET findings were known. FDG-PET detected unresectable pulmonary (n = 5) and hepatic metastases (n = 1) and ruled out extrahepatic (n = 2) and hepatic disease (n = 2). Due to FDG-PET, eight patients were spared unwarranted liver resection or laparotomy and two other patients were identified as candidates for liver resection. When the results of FDG-PET were regarded as decisive in a retrospective analysis, potential change of management was 29% (15 patients). FDG-PET and CDM showed discordant extrahepatic results in 11 patients (22%) and discordant hepatic results in eight patients (16%). Compared with CDM, FDG-PET resulted in true upstaging (n = 11), true downstaging (n = 5), false upstaging (n = 1), and false downstaging (n = 2). The detection rate of liver metastases on a lesion basis was generally better for computed tomography than for FDG-PET (80% v 65%); this was related to tumor size. </jats:p><jats:p> CONCLUSION: FDG-PET as a complementary staging method improves the therapeutic management of patients with colorectal liver metastases, especially by detecting unsuspected extrahepatic disease. </jats:p> |
Format: | E-Article |
Quelle: | American Society of Clinical Oncology (ASCO) (CrossRef) |
Sprache: | Englisch |