Document Detail


Positron emission tomography/computed tomographic scans compared to computed tomographic scans for detecting colorectal liver metastases: a systematic review.
MedLine Citation:
PMID:  21475005     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : To review diagnostic accuracy of positron emission tomography/computed tomography (PET/CT) for colorectal liver metastases.
BACKGROUND: : Colorectal liver metastases can be treated with surgical resection; however, recurrence is seen in 58% of patients. PET/CT may better detect extra-hepatic disease before surgery to more accurately identify eligible candidates for surgery and, through better selection, improve patient prognosis.
METHODS: : We conducted a comprehensive systematic review on adults with colorectal liver metastases who received PET/CT and CT scans to detect metastases. The gold standard to confirm the diagnosis was histology. Study selection, quality assessment, and data extraction were completed independently by 2 investigators. Pooling of results was not feasible because of heterogeneity. A qualitative summary of results is presented.
RESULTS: : From 1083 citations, we identified 6 studies (440 patients) for the review. For extra-hepatic lesions (3 studies; 178 patients), PET/CT was more sensitive than CT, but specificities were similar (PET/CT sensitivity [SN] = 75%-89% and specificity [SP] = 95%-96% vs. CT SN = 58%-64% and SP = 87%-97%). For hepatic lesions (5 studies; 316 patients), PET/CT had higher SN and SP than CT (PET/CT SN = 91%-100% and SP = 75%-100%; CT SN = 78%-94% and SP = 25%-98%). For local recurrence (3 studies; 206 patients), PET/CT also had better accuracy than CT with SN = 93% to 100% and SP = 97% to 98% versus SN = 0 %-100% and SP = 97%-98%.
CONCLUSION: : Based on this systematic review, we conclude that PET/CT has a higher accuracy for detection of extra-hepatic and hepatic colorectal metastatic disease than CT alone. However, the results are based on a small number of studies and should be interpreted cautiously.
Authors:
Seema Patel; Michael McCall; Arto Ohinmaa; David Bigam; Donna M Dryden
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  253     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  666-71     Citation Subset:  AIM; IM    
Affiliation:
*Departments of Public Health,. †Surgery,. ‡Pediatrics & Alberta Research Centre for Health Evidence, University of Alberta, Edmonton, Alberta, Canada.
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