Prospective evaluation of the impact of 18F-FDG Positron Emission Tomography (PET) in patients with resectable liver metastases from colorectal cancer

Background: To assess the potential additional value of positronemission tomography (PET) in patients with resectable liver metastasesfrom colorectal cancer, in comparison with computed tomography(CT)Method: a double-blind comparison of PET and thoraco-abdominalCT was performed prior to surgery in 53 patients. An histologicalexamination of resected metastases was performed in all patients.A double-blind comparative study of FDG-PET versus thoracoabdominalCT as the decision-making criterion, in preoperativestaging of resectable colorectal liver metastases. From October2001 to November 2002, fifty-three consecutive patients consideredeligible for liver resection after investigation with conventionaldiagnostic methods (CDM), entered the study. All included patientsunderwent laparotomy and histologic examination of resectedspecimen.Results: Malignant or benign suspected lesions detected by FDGPETand/or CT was confirmed by histologic examination in 95% ofcases. Overall sensitivity (71%) and accuracy (84%) of FDG-PETwas equivalent to those of CT (75% and 85% respectively). FDGPETsensitivity was equivalent to CT for hepatic sites (79%), butwas superior for extra-hepatic abdominal sites. PET provided additionalinformation in 5 (9,5%) patients, mainly by depicting extrahepaticmetastatic disease, whereas PET falsely upstaged 3 (5,6%)patients.Conclusion: In patients with potentially resectable liver metastasesaccording to recent CT-device, whole-body FDG-PET may help tofurther select patients with unrecognised extra-hepatic metastases.However, additional information provided by PET is not as reliableas suggested by earlier retrospective studies.