title: Positron emission tomography to stage suspected metastatic colorectal carcinoma to the liver.
abstract: BACKGROUND
  Accurate detection of recurrent colorectal carcinoma remains a clinical challenge. Positron emission tomography (PET) using 18F-fluorodeoxyglucose (18FDG) is an imaging technique that allows direct evaluation of cellular metabolism. 18F-fluorodeoxyglucose PET was compared to computed tomography (CT) and CT portography for staging metastatic colorectal carcinoma.
  
  
  METHODS
  Twenty-four patients previously treated for colorectal carcinoma who had suspected recurrence to the liver underwent an 18FDG PET scan of the entire body. All patients had either a CT scan of the abdomen (n = 17), a CT portogram (n = 18), or both (n = 11). The final diagnosis was obtained by tissue pathology in 19 patients and clinical follow-up in 5 patients.
  
  
  RESULTS
  A total of 60 suspicious lesions were identified. Of the 55 intrahepatic lesions, 39 were malignant and 16 were benign. Of the 5 extra-hepatic lesions, 4 were malignant. The 18FDG PET imaging had a higher accuracy (93%) than CT and CT portography (both 76%) in detecting metastatic disease to the liver, and detected unsuspected extrahepatic recurrence in 4 patients. Although the sensitivity of 18FDG PET (90%) was slightly lower than that of CT portography (97%), the specificity was much higher (100% versus 9%), including postsurgical sites. 18FDG PET altered surgical plans in 6 (25%) of 24 patients.
  
  
  CONCLUSIONS
  18FDG PET is extremely useful in staging patients with suspected metastatic colorectal carcinoma to the liver.
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2675, USA.
authors.forename: J V
authors.initials: JV
authors.lastname: Vitola
authors.forename: D
authors.initials: D
authors.lastname: Delbeke
authors.forename: M P
authors.initials: MP
authors.lastname: Sandler
authors.forename: M G
authors.initials: MG
authors.lastname: Campbell
authors.forename: T A
authors.initials: TA
authors.lastname: Powers
authors.forename: J K
authors.initials: JK
authors.lastname: Wright
authors.forename: W C
authors.initials: WC
authors.lastname: Chapman
authors.forename: C W
authors.initials: CW
authors.lastname: Pinson
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D003847:Deoxyglucose / Q000031:analogs & derivatives; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
chemical_list: D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose