AIM: To assess the clinical impact of 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG) positronemission tomographyecomputed tomography (PET-CT) in patients with potentially resectable metastatic colorectal cancer. MATERIALS AND METHODS: One hundred and two patients with potentially resectable metastatic colorectal cancer underwent FDG PET-CT in addition to conventional imaging over an 18-month period. The findings were compared to conventional imaging, with histological or clinico-radiological validation. The impact on subsequent management was evaluated using information from clinico-radiological databases. RESULTS: Of 102 patients (mean age 67 years, range 27e85 years), 94 had liver, five had isolated lung, and three had limited peritoneal metastases. In 31 patients (30%) PET-CT had a major impact on subsequent management, by correctly clarifying indeterminate lesions on conventional imaging as inoperable metastatic disease in 16 patients, detecting previously unsuspected metastatic disease in nine patients, identifying occult second primary tumours in three patients, and correctly down-staging three patients. PET-CT had a minor impact in 12 patients (12%), no impact in 49 cases (48%), and a potentially negative impact in 10 cases (10%). Following PET-CT, 36 (35%) patients were no longer considered for surgery. Of those remaining operative 45 of 66 (68%) underwent potentially curative metastatic surgery. In this cohort PET-CT saved 16 futile laparotomies. CONCLUSION: FDG PET-CT has a valuable role in selected patients with metastatic colorectal cancer by improving staging accuracy and characterizing indeterminate lesions and helps triage patients to the appropriate treatment.
Objective [F-18]-Fluorodeoxyglucose-positron emission tomography (FDG-PET) is used increasingly in the work-up to surgery for patients with potentially resectable colorectal liver metastases. This study evaluates the clinical effectiveness, impact on health care resources and cost-effectiveness of adding FDG-PET to the diagnostic algorithm alongside a randomized clinical trial from a health care perspective. Methods In a randomized clinical trial, the net monetary benefit (NMB) of FDG-PET added ...
#1Yiyan Liu(UMDNJ: University of Medicine and Dentistry of New Jersey)H-Index: 19
#2Nasrin Ghesani(UMDNJ: University of Medicine and Dentistry of New Jersey)H-Index: 11
Last. Lionel S. Zuckier(UMDNJ: University of Medicine and Dentistry of New Jersey)H-Index: 23
view all 3 authors...
A routine feature of positron emission tomography/computed tomography (PET/CT) imaging is whole-body acquisition that results in many unexpected findings identified outside of the primary region of abnormality. Furthermore, 18 F-fluorodeoxyglucose (FDG) is a marker of glycolysis and does not specifically accumulate in malignancy. Understanding the physiology and pathophysiology of normal FDG distribution and common incidental findings is therefore essential to the physician interpreting whole-bo...
PET and PET/CT have changed the diagnostic algorithm in oncology. Health care systems worldwide have recently approved reimbursement for PET and PET/CT for staging of non-small cell lung cancer and differential diagnosis of solitary pulmonary nodules because PET and PET/CT have been found to be cost-effective for those uses. Additional indications that are covered by health care systems in the United States and several European countries include staging of gastrointestinal tract cancers, breast ...
Last. Otto Hoekstra(Radboud University Nijmegen)H-Index: 2
view all 5 authors...
Abstract. The aim of the study was to define the cost-effectiveness of whole-body (18)F-FDG PET, as compared with chest CT, in screening for distant metastases in patients with head and neck squamous cell carcinoma (HNSCC). METHODS: In a multicenter prospective study, 145 consecutive patients with high risk factors for distant metastases and scheduled for extensive treatment underwent chest CT and whole-body (18)F-FDG PET for screening of distant metastases. The cost data of 80 patients in whom ...
Summary Early studies of liver resection for colorectal cancer metastases identified patients with concomitant extrahepatic disease as a group with poor outcomes. These studies concluded that the presence of extrahepatic disease should be a contraindication to resection. This contraindication has more recently been challenged. In this paper, we review the published work on metastatic colorectal cancer, pertaining to the role of surgery in patients with liver metastases and concomitant extrahepat...
Last. Wim J.G. Oyen(Radboud University Nijmegen)H-Index: 110
view all 10 authors...
With the increasing possibilities for surgical treatment of colorectal liver metastases, careful selection of patients who may benefit from surgical treatment becomes critical. The addition of PET to (18)F-FDG may significantly improve conventional staging by CT. Up to now, definitive evidence that the addition of (18)F-FDG PET to conventional staging leads to superior clinical results and improved clinical management in these patients has been lacking. In this randomized controlled trial in pat...
#1Shiva Badiee(UCSF: University of California, San Francisco)H-Index: 3
#2Benjamin L. Franc(UCSF: University of California, San Francisco)H-Index: 26
Last. Fergus V. Coakley(UCSF: University of California, San Francisco)H-Index: 63
view all 6 authors...
OBJECTIVE. The purpose of our study was to investigate the role of IV iodinated contrast material in the evaluation of hepatic metastases at 18F-FDG PET/CT.MATERIALS AND METHODS. We retrospectively identified 39 patients (25 men and 14 women) with suspected isolated hepatic metastases from colorectal cancer who underwent FDG PET/CT. The CT protocol included acquisition of unenhanced and multiphase contrast-enhanced CT images through the liver. At two separate sittings, four readers (two radiolog...
Purpose Under Medicare’s Coverage with Evidence Development policy, positron emission tomography (PET)/computed tomography (CT) and PET became covered services for previously noncovered cancer indications if prospective registry data were collected. The National Oncologic PET Registry (NOPR) was developed to meet these coverage requirements and to assess how PET affects care decisions. Methods The NOPR collected questionnaire data from referring physicians on intended patient management before a...
Purpose The purpose of this study is to evaluate the accuracy of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) with intravenous contrast for depiction of recurrent pancreatic cancer, compared with PET/non-enhanced CT and CT.
Being the most common gastrointestinal cancer and the second most common cause of cancer deaths, colorectal cancer is a major health problem. Risk factors for colorectal cancer are variable and include dietary, hereditary, and environmental factors.
Last. Emmanuel Huguet(Cambridge University Hospitals NHS Foundation Trust)H-Index: 6
view all 15 authors...
The liver is the commonest site of metastatic disease for patients with colorectal cancer, with at least 25% developing colorectal liver metastases (CRLM) during the course of their illness. The management of CRLM has evolved into a complex field requiring input from experienced members of a multi-disciplinary team involving radiology (cross sectional, nuclear medicine and interventional), Oncology, Liver surgery, Colorectal surgery, and Histopathology. Patient management is based on assessment ...
OBJECTIVE The liver is the most frequent metastatic site from colorectal cancer and about 20% of these patients are treated by surgical resection. However, the 5-year disease-free survival (DFS) following resection is only about 25% and 5-year overall survival (OS) about 38%. The aim of the study was to evaluate the ability of metabolic and volumetric measurements from fluorine-18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) prior to resection for colorectal liver metastases (CLM) to ...
#1Majid Assadi(Bushehr University of Medical Sciences)H-Index: 20
Positron emission tomography (PET) has been established as a powerful modality in staging, restaging/recurrence, prognostication, and treatment planning for many malignancies, and its use in precision oncology is currently increasing. This chapter reviews the current state-of-the-art use of PET and PET/CT in the management of patients with gastrointestinal cancers, including esophagus, gastric, stroma cell, and colorectal, pancreatic, and liver malignancies, with reference to the currently avail...
Last. Svein Dueland(Oslo University Hospital)H-Index: 27
view all 3 authors...
Liver resection is the only potential curative treatment for colorectal liver metastases, but only a minority of about 20–25% becomes resectable. Liver transplantation offers the prospect of an R0 resection in otherwise inoperable patients. Early attempts during the two last decades of the previous millennium were hampered by poor survival and the practice was abandoned.
Introduction/Background The aim of the study was to assess morphological predictors for lymph node metastases (Stage III disease) in colon cancer on computed tomography.
Last. Sung-Ae Jung(Ewha Womans University)H-Index: 19
view all 12 authors...
This study aimed to investigate the correlations between diffuse splenic Fluorine-18-fluorodeoxyglucose (18F-FDG) uptake on positron emission tomography/computed tomography (PET/CT) and inflammatory markers and to evaluate the prognostic significance of splenic FDG uptake in rectal cancer patients who underwent curative surgery. We retrospectively analyzed the data from 161 patients who underwent splenic FDG PET/CT staging and subsequent curative surgical resection of rectal cancer between July ...
#2Beth-Ann Shanker(Mercy Medical Center (Baltimore, Maryland))H-Index: 4
The total mesorectal excision (TME) for rectal cancer involves high ligation of the inferior mesenteric artery (IMA) and complete removal of the rectum and mesorectal fascia without damage to the specimen. A well-executed TME has been proven to decrease local recurrence, operative blood loss, and perseveration of urologic and sexual function. Robotic surgery allows for improved visualization of the deep pelvis with instruments that allow for wristed movement and three-dimensional visualization. ...
AbstractIntroduction: CRS and HIPEC confer survival benefit in selected patients with peritoneal metatases (PM). Accurate preoperative assessment of disease burden and exclusion of distant metastases are crucial in selecting the appropriate patient. We evaluate the utility of PET-CT scans in comparison with CT and MRI scans in patients considered for CRS and HIPEC.Methods: Data were retrospectively collected from patients who had been discussed for CRS and HIPEC between January 2011 and December...
: MRI provides considerable advantages for imaging of patients with peritoneal tumor. Its inherently superior contrast resolution compared with computed tomography allows MRI to more accurately depict small peritoneal tumors that are often missed on other imaging tests. Combining different contrast mechanisms, including diffusion-weighted MRI and gadolinium-enhanced MRI, provides a powerful tool for preoperative and surveillance imaging in patients being considered for cytoreductive surgery and ...