title: Imaging in resectable colorectal liver metastasis patients with or without preoperative chemotherapy: results of the PROMETEO-01 study.
abstract: BACKGROUND
  The aim of the PROMETEO-01 Study was to define the diagnostic accuracy of imaging techniques in colorectal cancer liver metastasis (CRCLM) patients.
  
  
  METHODS
  Patients referred to Bologna S. Orsola-Malpighi Hospital performed a computed-tomography scan (CT), magnetic resonance (MR), 18F-FDG-PET/CTscan (PET/CT) and liver contrast-enhanced-ultrasound (CEUS); CEUS was also performed intraoperatively (i-CEUS). Every pathological lesion was compared with imaging data.
  
  
  RESULTS
  From December 2007 to August 2010, 84 patients were enrolled. A total of 51 (60.71%) resected patients were eligible for analysis. In the lesion-by-lesion analysis 175 resected lesions were evaluated: 67(38.3%) belonged to upfront resected patients (group-A) and 108 (61.7%) to chemotherapy-pretreated patients (group-B). In all patients the sensitivity of MR proved better than CT (91% vs 82%; P=0.002), CEUS (91 vs 81%; P=0.008) and PET/CT (91% vs 60%; P=0.000), whereas PET/CT showed the lowest sensitivity. In group-A the sensitivity of i-CEUS, MR, CT, CEUS and PET/CT was 98%, 94%, 91%, 84% and 78%, respectively. In group-B the i-CEUS proved equivalent in sensitivity to MR (95% and 90%, respectively, P=0.227) and both were significantly more sensitive than other procedures. The CT sensitivity in group-B was lower than in group-A (77% vs 91%, P=0.024).
  
  
  CONCLUSIONS
  A thoraco-abdominal CT provides an adequate baseline evaluation and guides judgment as to the resectability of CRCLM patients. In the subset of candidates for induction chemotherapy to increase the chance of liver resection, the most rational approach is to add MR for the staging and restaging of CRCLM.
authors.affiliation: Medical Oncology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: F L
authors.initials: FL
authors.lastname: Rojas Llimpe
authors.affiliation: Medical Oncology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Di Fabio
authors.affiliation: Liver Surgery Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ercolani
authors.affiliation: Radiology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Giampalma
authors.affiliation: Radiology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cappelli
authors.affiliation: Internal Medicine Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Serra
authors.affiliation: Nuclear Medicine Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Castellucci
authors.affiliation: Pathology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: A
authors.initials: A
authors.lastname: D'Errico
authors.affiliation: Radiology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Golfieri
authors.affiliation: Liver Surgery Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: A D
authors.initials: AD
authors.lastname: Pinna
authors.affiliation: Medical Oncology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pinto
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D060828:Induction Chemotherapy; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18