ABSTRACT
18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a useful functional
imaging method that complements conventional anatomic imaging modalities for screening
patients with colorectal hepatic metastases and hepatocellular cancer to determine
their suitability for interventional procedures. FDG PET is more sensitive in detecting
colorectal cancer than hepatocellular cancer (~90% versus ~50%). The likelihood of
detecting hepatic malignancy with FDG PET rapidly diminishes for lesions smaller than
1 cm. The greatest value of FDG PET in these patients is in excluding extrahepatic
disease that might lead to early recurrence after interventional therapy. Promising
results have been reported with FDG PET that may show residual (local) or recurrent
disease before conventional imaging methods in patients receiving interventional therapy.
For patients with colorectal hepatic metastases, many investigators believe that patients
with PET evidence of recurrent hepatic disease should receive additional treatment
even when there is no confirmatory evidence present on other methodologies. For patients
with hepatocellular cancer no conclusions regarding the value of FDG PET for assessment
of response to interventional therapy can be reached as there is almost no published
data.
KEYWORDS
PET - FDG - colorectal cancer - hepatocellular cancer
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Robert S HellmanM.D.
Nuclear Medicine, Froedtert Hospital
9200 W. Wisconsin Avenue, Milwaukee, WI 53226