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Prospective evaluation of ^(18)F-FDG positron emission tomography in the preoperative staging of patients with hepatic colorectal metastases

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Hepatobiliary Surgery and Nutrition 2022年第4期11卷 539-554页

作者： tim akhurst Mithat Gönen Raymond E.Baser Lawrence H.Schwartz Scott Tuorto Lynn A.Brody Anne Covey Karen T.Brown Steven M.Larson Yuman Fong Department of Radiology Memorial Sloan-Kettering Cancer CenterNew YorkNYUSA Peter MacCallum Cancer Centre VictoriaAustralia Department of Epidemiology and Biostatistics Memorial Sloan-Kettering Cancer CenterNew YorkNYUSA Department of Surgery Memorial Sloan-Kettering Cancer CenterNew YorkNYUSA

Background:Despite considerable advances in preoperative imaging,up to one-third of patients operatively explored for hepatic colorectal metastases are unexpectedly found to harbor unresectable intrahepatic or extrahepatic ***:The current study is a prospective,blinded study comparing utility of[18F]2-fluoro-2-deoxyglucose positron emission tomography(18F-FDG-PET)to computed tomography(CT)and CT arterial portography(CTAP)as preoperative ***:The 125 planned subjects were *** seen on FDG-PET alone changed therapy for 23 of 125 patients(18%).FDG-PET confirmed other radiologic findings in 16 cases(13%),for an overall influence on therapy in 39 cases(31%).FDG-PET was the most sensitive diagnostic imaging test for extrahepatic cancer;it was 80-90%sensitive for extrahepatic cancer and 70-90%*** the 28 cases of unresectable disease due to extrahepatic disease,FDG-PET findings solely changed therapies in 16 cases(57%)and influenced therapy in seven other cases(25%).Of the 21 unresectable cases due to extent of intrahepatic disease,FDG-PET did not solely change therapy in ***,FDG-PET had the lowest sensitivity for hepatic sites compared with CT or *** particular,small(<1 cm)liver tumors were particularly poorly detected by *** area under the receiver operating characteristic(ROC)curve for small tumors was 0.58 and for patients on chemotherapy it was 0.66,a modest improvement over no ***:FDG-PET is an important test for preoperative staging of patients with hepatic colorectal metastases,affecting treatment decisions in nearly one-third of *** high yield is due mainly to detection of extrahepatic *** is therefore recommended in patients with extrahepatic lesions suspected to be disseminated cancer or those with high risk for extrahepatic *** is not a good test for identification of small tumors in the liver.

关键词： Positron emission tomography(PET) computed tomography(CT) colorectal hepatic metastases surgery

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