Document Detail


Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG-PET-CT.
MedLine Citation:
PMID:  17937421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Combined fluorine 18-fluorodeoxyglucose-positron emission tomography-CT imaging has been shown to be of good diagnostic value in the preoperative evaluation of patients with colorectal cancer and liver metastases. The adjunctive use of intraoperative sonography (IOUS) may have a limited impact on treatment selection in these patients. PURPOSE: To compare the diagnostic performance of preoperative positron emission tomography (PET)-CT alone and PET-CT combined with IOUS in the evaluation of patients who are considered for curative resection of hepatic metastases from colorectal carcinoma. MATERIALS AND METHODS: Patients with colorectal cancer who underwent resection of hepatic metastases and preoperative PET-CT (with or without contrast-enhanced CT) and IOUS were identified. The performance of the imaging techniques was evaluated through review of the radiologic reports, correlation with surgical and histopathologic findings, and clinical follow-up. RESULTS: Thirty-one patients (mean age, 63.5 years [range, 53-82 years]) were analyzed. Fifteen patients had received preoperative chemotherapy. The mean interval between PET-CT and IOUS was 22.6 days (range, 1-56 days). In 4 cases, neither PET-CT nor IOUS correctly diagnosed the liver metastases. In all 31 patients, the sensitivity of PET-CT alone and PET-CT combined with IOUS was 63% (95% CI 44-80%) and 93% (95% CI 78-98%), respectively; the positive predictive value was 81% and 89%, respectively. In patients without preoperative chemotherapy (n = 16), the sensitivity of PET-CT alone and PET-CT combined with IOUS was 77% (95% CI 49-94%) and 100% (95% CI 79-100%), respectively. In 11 cases (35%), IOUS altered the surgical strategy. CONCLUSION: In patients with colorectal carcinoma and potentially resectable liver metastases on preoperative PET-CT, IOUS can provide additional information that may alter decision making with regard to surgical technique.
Authors:
Stephan M Wildi; Christoph Gubler; Thomas Hany; Henrik Petrowsky; Pierre A Clavien; Wolfram Jochum; Tilman Gerlach; Michael Fried; Beat Mullhaupt
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of clinical ultrasound : JCU     Volume:  36     ISSN:  0091-2751     ISO Abbreviation:  J Clin Ultrasound     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-10     Completed Date:  2008-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401663     Medline TA:  J Clin Ultrasound     Country:  United States    
Other Details:
Languages:  eng     Pagination:  20-6     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley Periodicals, Inc.
Affiliation:
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital of Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Colorectal Neoplasms / pathology*
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Intraoperative Care / methods*
Liver Neoplasms / diagnosis*,  secondary*,  surgery
Male
Middle Aged
Positron-Emission Tomography / statistics & numerical data
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Tomography, X-Ray Computed / statistics & numerical data
Ultrasonography / methods*,  statistics & numerical data
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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