An audit of fusion CT-PET in the management of colorectal liver metastases.
OBJECTIVE
To assess the use of positron emission tomography combined with computerized tomography (CT-PET) with fluoro-18-2-deoxy-d-glucose ((18)F-FDG) to identify hyper-metabolic tumours, especially colorectal metastases (CRM).


METHODS
Patient particulars, diagnoses and clinical outcome for each patient were studied. Twenty-three patients underwent CT-PET, 10 males and 13 females, median age 59 (range 34-72). Fourteen patients presented with primary liver CRM and nine had undergone previous liver resections. Indications for CT-PET included; suspected extrahepatic disease in 13/23 patients, possible hepatic recurrence 5/23 and clinical suspicion in 8/23 patients.


RESULTS
Seven patients had a major impact on their management. Unexpected (not seen on CT) findings in the CRM group included, 7/23 (30%) patients with extrahepatic disease, 3/23 with hepatic metastases, 8/23 suspected of having liver or distant metastases on CT had a negative study. A clinical decision, based on the CT-PET report, could be undertaken in 21/23 patients.


CONCLUSIONS
CT-PET is useful in patients with CRM where conventional imaging presents dilemmas such as: assessment of suspected extrahepatic disease, recurrence in liver, patients with advanced or perforated initial tumours.
Khan
S
S
Liver Unit (Liver Transplantation and Hepatobiliary Surgery), University Hospital Birmingham, Queen Elizabeth, Edgbaston, UK. saboor.711@gmail.com
Tan
Y M
YM
John
A
A
Isaac
J
J
Singhvi
S
S
Guest
P
P
Mirza
D F
DF
D000310:Adrenal Gland Neoplasms / Q000556:secondary; D000328:Adult; D000368:Aged; D003110:Colonic Neoplasms / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012004:Rectal Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18