[F-18] fluorodeoxyglucose positron emission tomography as a tool for early recognition of incomplete tumor destruction after radiofrequency ablation for liver metastases.
OBJECTIVE
To assess the value of FDG positron emission tomography (PET) for early detection of incomplete tumor destruction after radiofrequency ablation (RFA) for liver metastasis.


METHODS
Twenty-eight unresectable liver metastases in 17 patients were treated by RFA. Patients underwent computed tomography (CT) and FDG-PET preoperatively, at 1 week, 1 month, and 3 months postoperatively. Postoperative CT and FDG-PET at 1 week and 1 month were analyzed to identify hypervascular and hypermetabolic residual tumors at the RFA site. These results were correlated with follow-up CT and, in case of reintervention, with pathologic results.


RESULTS
In 24/28 of RFA-treated metastases, CT and FDG-PET at 1 week and 1 month showed no tumor residues. During follow-up, none of these 13 patients developed local recurrence at RFA site. In four patients, FDG-PET at 1 week and 1 month showed peripheral hypermetabolic residue after RFA, whereas CT did not revealed residual tumor. In three patients, local persistence of viable tumor cells was biopsy-proven at reintervention. In the fourth, follow-up CT showed subsequent development of a local recurrence.


CONCLUSIONS
FDG-PET accurately monitors the local efficacy of RFA for treatment of liver metastases, as it early recognizes incomplete tumor ablation, not detectable on CT.
Donckier
Vincent
V
Medicosurgical Department of Gastroenterology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium. vdonckie@ulb.ac.be
Van Laethem
Jean Luc
JL
Goldman
Serge
S
Van Gansbeke
Daniel
D
Feron
Pascale
P
Ickx
Brigitte
B
Wikler
David
D
Gelin
Michel
M
D001943:Breast Neoplasms / Q000473:pathology; D017115:Catheter Ablation; D003110:Colonic Neoplasms / Q000473:pathology; D018572:Disease-Free Survival; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011184:Postoperative Period; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18