Endoscopy 2004; 36 - 24
DOI: 10.1055/s-2004-834512

The Diagnostic Accuracy of FDG PET in the Detection of Recurrence of Colorectal Carcinoma and its Affect on Intention to Treat

JJ Sheehan 1, EVM Ward 1, CA Ridge 1, SE Harte 1, GJ Duffy 1, DE Malone 1, SJ Skehan 1
  • 1Department of Radiology, St. Vincent's University Hospital, Dublin 4. PET Centre, Blackrock Clinic, Co Dublin

Aim: This study retrospectively evaluated the clinical impact of PET in staging and management of colorectal liver metastases (CRCLM).

Methods: We selected consecutive patients with colorectal carcinoma who had PETšpre liver resection.š Radiologists reviewed PET images and compared these with conventional imaging (CT/MRI).š Patient records were reviewed to establish surgical intentions before and after PET.

Results: From July 2002-Dec 2003, 40 patients (M=25, F=15) met inclusion criteria.š 95% (n=38) had abnormal PET results.š Of these, 47% (n=18) underwent hepatic resection.š Diagnostic Impact: Discordance between PET and conventional imaging 64% (n=24); which was predominantly tumour upstaging (70%) by PET.šš Management Impact: Management change after PET 35%š (n=14); planned surgery cancelled 78% (n=11) .šš Surgical findings correlated with PET findings in 89% (n=16).š The discordances 11% (n=2),šš (1 patient with tumour adherent to diaphragm; 1 young patient with an equivocal PET result) were unresectable at laparotomy.š 24% n=5 patients with limited extrahepatic disease on PET underwent laparotomy and CRCLM resection.š

Conclusion: PET has a major impact on staging and management of CRCLM.šš Extrahepatic metastases are not an absolute contraindication to liver resection.š