Additional Value of FDG-PET/CT in Management of "Solitary" Liver Metastases: Preliminary Results of a Prospective Multicenter Study

被引:25
作者
Grassetto, Gaia [1 ]
Fornasiero, Adriano [2 ]
Bonciarelli, Giorgio [3 ]
Banti, Elena [1 ]
Rampin, Lucia [1 ]
Marzola, Maria Cristina [1 ]
Massaro, Arianna [1 ]
Galeotti, Fabrizio [4 ]
Del Favero, Giuseppe [5 ]
Pasini, Felice [6 ]
Minicozzi, Anna Maria [7 ]
Al-Nahhas, Adil [8 ]
Cordiano, Claudio [7 ]
Rubello, Domenico [1 ]
机构
[1] Santa Maria della Misericordia Hosp, Dept Nucl Med, PET Ctr, I-45100 Rovigo, Italy
[2] Gen Hosp, Dept Oncol, Padua, Italy
[3] Gen Hosp Este Monselice, Dept Oncol, Padua, Italy
[4] S Maria della Misericordia Hosp, Dept Gen Surg, Rovigo, Italy
[5] S Maria della Misericordia Hosp, Dept Internal Med, Unit Endoscopy, Rovigo, Italy
[6] S Maria della Misericordia Hosp, Dept Oncol, Rovigo, Italy
[7] Univ Verona, Dept Surg, I-37100 Verona, Italy
[8] Hammersmith Hosp, PET Ctr, Dept Nucl Med, London, England
关键词
Solitary liver metastasis; Surgical resection; Conventional imaging; FDG-PET/CT; COLORECTAL-CANCER; EMISSION-TOMOGRAPHY; HEPATIC METASTASES; F-18-FDG PET/CT; CT; METAANALYSIS; DIAGNOSIS; RESECTION; DISEASE; IMPACT;
D O I
10.1007/s11307-009-0249-5
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The most common malignancy affecting the liver is metastasis from a wide variety of tumors, particularly those of gastrointestinal origin. Successful surgical removal of a solitary liver metastasis may significantly extend survival and optimal preoperative assessment in this regard is a mandatory prerequisite for proper patient selection. The addition of positron emission tomography/computed tomography (PET/CT) to other more conventional imaging procedures (e.g., ultrasound (US), CT, and magnetic resonance) has the potential to greatly improve the selection process by the combination of high-resolution anatomy afforded by CT directly combined with the functional scintigraphic map of intra- and extrahepatic lesions depicted by 2-deoxy-2-[F-18]fluoro-d-glucose (FDG)-PET. In this study, we assess the additional value of PET/CT in the management strategy of patients with solitary liver metastasis from colorectal and other cancers identified by conventional imaging methods. We evaluated 43 consecutive patients (17 males, 26 females, mean age 53 +/- 6 years) with known solitary liver metastasis. This sample consisted of 18 patients with colorectal cancer, 15 with nonsmall cell lung cancer, six with breast carcinoma, and four ovarian cancers. In addition to contrast-enhanced CT and US, all patients were studied with FDG-PET/CT before surgery. PET/CT was performed within 3 weeks of the initial diagnosis and the scans were read by two experienced radiologists/nuclear medicine specialists blinded to the clinical data. A final diagnosis was obtained at surgery in 31 patients, by fine needle biopsy in five, and long-term clinical, biochemical, and follow-up imaging in seven patients. In 12 out of 43 patients (28%), PET/CT resulted in restaging disease and a change in therapy. Twenty-two of 31 patients with confirmed solitary liver lesions (71%) were disease-free, eight of 31 (26%) developed a new recurrence, and one of 31 (3%) died from disease progression over a 17 +/- 6-month follow-up interval. Nine of 12 patients (75%) with multiple metastases demonstrated by FDG-PET/CT were alive with disease and three of 12 (25%) deceased due to disease progression (p < 0.01) over a 17 +/- 6-month follow-up interval. The addition of FDG-PET/CT to the routine assessment of patients with liver metastasis has a significant impact on disease staging and selection of suitable candidates for solitary liver metastasis resection and outcome.
引用
收藏
页码:139 / 144
页数:6
相关论文
共 19 条
[1]   Diagnosis and treatment of metastatic disease to the liver [J].
Arciero, Cletus A. ;
Sigurdson, Elin R. .
SEMINARS IN ONCOLOGY, 2008, 35 (02) :147-159
[2]   Colorectal liver metastases: CT, MR imaging, and PET for diagnosis - Meta-analysis [J].
Bipat, S ;
van Leeuwen, MS ;
Comans, EFI ;
Pijl, MEJ ;
Bossuyt, PMM ;
Zwinderman, AH ;
Stoker, J .
RADIOLOGY, 2005, 237 (01) :123-131
[3]   The impact of 18F-FDG PET/CT in patients with liver metastases [J].
Chua, Siew C. ;
Groves, Ashley M. ;
Kayani, Irfan ;
Menezes, Leon ;
Gacinovic, Svetislav ;
Du, Yong ;
Bomanji, Jamshed B. ;
Ell, Peter J. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2007, 34 (12) :1906-1914
[4]   Positron emission tomography affects surgical management in recurrent colorectal cancer patients [J].
Desai, DC ;
Zervos, EE ;
Arnold, MW ;
Burak, WE ;
Mantil, J ;
Martin, EW .
ANNALS OF SURGICAL ONCOLOGY, 2003, 10 (01) :59-64
[5]  
Figueras J, 1997, Liver Transpl Surg, V3, P617, DOI 10.1002/lt.500030611
[6]   Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer - Analysis of 1001 consecutive cases [J].
Fong, Y ;
Fortner, J ;
Sun, RL ;
Brennan, MF ;
Blumgart, LH .
ANNALS OF SURGERY, 1999, 230 (03) :309-318
[7]  
Haguet EL, 2007, HEPATO-GASTROENTEROL, V54, P1667
[8]  
Hicks Rodney J, 2006, Cancer Imaging, V6, pS52, DOI 10.1102/1470-7330.2006.9012
[9]   Detection of hepatic metastases from cancers of the gastrointestinal tract by using noninvasive imaging methods (US, CT, MR imaging, PET): A meta-analysis [J].
Kinkel, K ;
Lu, Y ;
Both, M ;
Warren, RS ;
Thoeni, RF .
RADIOLOGY, 2002, 224 (03) :748-756
[10]   The use of 18F-FDG PET/CT in colorectal liver metastases-comparison with CT and liver MRI [J].
Kong, G. ;
Jackson, C. ;
Koh, D. M. ;
Lewington, V. ;
Sharma, B. ;
Brown, G. ;
Cunningham, D. ;
Cook, G. J. R. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2008, 35 (07) :1323-1329