title: Assessment of local control after laser-induced thermotherapy of liver metastases from colorectal cancer: contribution of FDG-PET in patients with clinical suspicion of progressive disease.
abstract: BACKGROUND
  Management of patients after locally ablative treatment of liver metastases requires exact information about local control and systemic disease status. To fulfill these requirements, whole-body imaging using positron emission tomography with (18)F-fluorodeoxyglucose (FDG-PET) is a promising alternative to morphologic imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI).
  
  
  OBJECTIVE
  To evaluate FDG-PET for the assessment of local control and systemic disease in patients with clinical suspicion of tumor progression after laser-induced thermotherapy (LITT) of colorectal liver metastases.
  
  
  METHODS
  In 21 patients with suspicion of progressive disease after LITT, whole-body FDG-PET was performed. The presence of viable tumor within treated lesions, new liver metastases, and extrahepatic disease was evaluated visually and semiquantitatively (maximal standard uptake value [SUV(max)], tumor-to-normal ratio [T/N]). The standard of reference was histopathology (n = 25 lesions) and/or clinical follow-up (>12 months) including contrast-enhanced MRI of the liver.
  
  
  RESULTS
  Among 54 metastases treated with LITT, 29 had residual tumor. Receiver operating characteristic (ROC) analysis of SUV(max) (area under the curve (AUC) 0.990) and T/N (AUC 0.968) showed a significant discrimination level of negative or positive lesion status with an equal accuracy of 94% (51/54). The overall accuracy of visual FDG-PET was 96% (52/54), with one false-negative lesion among six examined within 3 days after LITT, and one false-positive lesion examined 54 days after LITT. In the detection of new intra- and extrahepatic lesions, FDG-PET resulted in correct alteration of treatment strategy in 43% of patients (P = 0.007).
  
  
  CONCLUSIONS
  FDG-PET is a promising tool for the assessment of local control and whole-body restaging in patients with clinical suspicion of tumor progression after locally ablative treatment of colorectal liver metastases with LITT.
authors.affiliation: Klinik für Strahlenheilkunde, Bereiche Radiologie und Nuklearmedizin, Medizinische Klinik mit Schwerpunkt Hämatologie Onkologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Denecke
authors.forename: I
authors.initials: I
authors.lastname: Steffen
authors.forename: B
authors.initials: B
authors.lastname: Hildebrandt
authors.forename: R
authors.initials: R
authors.lastname: Rühl
authors.forename: F
authors.initials: F
authors.lastname: Streitparth
authors.forename: L
authors.initials: L
authors.lastname: Lehmkuhl
authors.forename: J
authors.initials: J
authors.lastname: Langrehr
authors.forename: J
authors.initials: J
authors.lastname: Ricke
authors.forename: H
authors.initials: H
authors.lastname: Amthauer
authors.forename: E Lopez
authors.initials: EL
authors.lastname: Hänninen
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000473:pathology*; D003951:Diagnostic Errors; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D053685:Laser Therapy / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D019788:Fluorodeoxyglucose F18