OBJECTIVE: Yttrium-90 radioembolisation (Y90-RE) is recommended for unresectable, chemorefractory liver-dominant disease; however, the incidence of extrahepatic disease (EHD) is high. FDG-PET may have additional value to CT in demonstrating EHD. Our aim was to evaluate the added diagnostic value of FDG-PET to abdominal CT and study the influence of FDG-PET findings on treatment decisions. METHODS: All consecutive patients with colorectal cancer liver metastases (CRCLM) referred for Y90-RE were included. Patients who underwent both CT and FDG-PET in the diagnostic workup were selected. Imaging reports were scrutinised for documented sites of EHD, and changes of management due to FDG-PET findings were determined. RESULTS: A total of 42 patients were included. Findings on CT and FDG-PET matched in 20 patients (no EHD, n = 15; identical EHD, n = 5). In 4 patients, lesions detected on CT were not FDG-avid, and in 18 patients, FDG-PET showed more lesions than CT (P < 0.05). In 7/42 patients (17 %) a change of management was made based on the additional FDG-PET findings, i.e. exclusion from Y90-RE treatment (n = 6) and change in treatment plan (whole liver rather than segmental treatment, n = 1). CONCLUSIONS: In patients with CRCLM referred for Y90-RE, FDG-PET showed significantly more EHD and led to a considerable change of management.
OBJECTIVE:Yttrium-90 radioembolisation (Y90-RE) is recommended for unresectable, chemorefractory liver-dominant disease; however, the incidence of extrahepatic disease (EHD) is high. FDG-PET may have additional value to CT in demonstrating EHD. Our aim was to evaluate the added diagnostic value of FDG-PET to abdominal CT and study the influence of FDG-PET findings on treatment decisions. METHODS: All consecutive patients with colorectal cancer liver metastases (CRCLM) referred for Y90-RE were included. Patients who underwent both CT and FDG-PET in the diagnostic workup were selected. Imaging reports were scrutinised for documented sites of EHD, and changes of management due to FDG-PET findings were determined. RESULTS: A total of 42 patients were included. Findings on CT and FDG-PET matched in 20 patients (no EHD, n = 15; identical EHD, n = 5). In 4 patients, lesions detected on CT were not FDG-avid, and in 18 patients, FDG-PET showed more lesions than CT (P < 0.05). In 7/42 patients (17 %) a change of management was made based on the additional FDG-PET findings, i.e. exclusion from Y90-RE treatment (n = 6) and change in treatment plan (whole liver rather than segmental treatment, n = 1). CONCLUSIONS: In patients with CRCLM referred for Y90-RE, FDG-PET showed significantly more EHD and led to a considerable change of management.
Authors: Guy Van Hazel; Anthony Blackwell; James Anderson; David Price; Paul Moroz; Geoff Bower; Giuseppe Cardaci; Bruce Gray Journal: J Surg Oncol Date: 2004-11-01 Impact factor: 3.454
Authors: M A D Vente; M Wondergem; I van der Tweel; M A A J van den Bosch; B A Zonnenberg; M G E H Lam; A D van Het Schip; J F W Nijsen Journal: Eur Radiol Date: 2008-11-07 Impact factor: 5.315
Authors: Ravi Murthy; Daniel B Brown; Riad Salem; Steven G Meranze; Douglas M Coldwell; Sunil Krishnan; Rodolfo Nunez; Amit Habbu; David Liu; William Ross; Alan M Cohen; Michael Censullo Journal: J Vasc Interv Radiol Date: 2007-04 Impact factor: 3.464
Authors: Andrew S Kennedy; Patrick McNeillie; William A Dezarn; Charles Nutting; Bruno Sangro; Dan Wertman; Michael Garafalo; David Liu; Douglas Coldwell; Michael Savin; Tobias Jakobs; Steven Rose; Richard Warner; Dennis Carter; Stephen Sapareto; Subir Nag; Seza Gulec; Allison Calkins; Vanessa L Gates; Riad Salem Journal: Int J Radiat Oncol Biol Phys Date: 2009-01-20 Impact factor: 7.038