Document Detail


Preoperative Staging of Patients with Liver Metastases of Colorectal Carcinoma. Does PET/CT Really Add Something to Multidetector CT?
MedLine Citation:
PMID:  21431987     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: This study was designed to determine prospectively whether the systematic use of PET/CT associated with conventional techniques could improve the accuracy of staging in patients with liver metastases of colorectal carcinoma. We also assessed the impact on the therapeutic strategy. METHODS: Between 2006 and 2008, 97 patients who were evaluated for resection of LMCRC were prospectively enrolled. Preoperative workup included multidetector-CT (MDCT) and PET/CT. In 11 patients with liver steatosis or iodinated contrast allergy, MR also was performed. Sixty-eight patients underwent laparotomy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values for hepatic and extrahepatic staging of MDCT and PET-CT were calculated. RESULTS: In a lesion-by-lesion analysis of the hepatic staging, the sensitivity of MDCT/RM was superior to PET/CT (89.2 vs. 55%, p < 0.001). On the extrahepatic staging, PET/CT was superior to MDCT/MR only for the detection of locoregional recurrence (p = 0.03) and recurrence in uncommon sites (p = 0.016). New findings in PET/CT resulted in a change in therapeutic strategy in 17 patients. However, additional information was correct only in eight cases and wrong in nine patients. CONCLUSIONS: PET/CT has a limited role in hepatic staging of LMCRC. Although PET-CT has higher sensitivity for the detection of extrahepatic disease in some anatomic locations, its results are hampered by its low PPV. PET/CT provided additional useful information in 8% of the cases but also incorrect and potentially harmful data in 9% of the staging. Our findings support a more selective use of PET/CT, basically in patients with high risk of local recurrence.
Authors:
Emilio Ramos; Carlos Valls; Laura Martinez; Laura Lladó; Jaume Torras; Sandra Ruiz; Cristina Gamez; Teresa Serrano; Joan Fabregat; Antonio Rafecas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-24
Journal Detail:
Title:  Annals of surgical oncology     Volume:  -     ISSN:  1534-4681     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain, eramos@bellvitgehospital.cat.
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