Article

Efficacy of fluorine-18-deoxyglucose positron emission tomography in detecting tumor recurrence after local ablative therapy for liver metastases: a prospective study.

Department of Surgery, University Medical Center Nijmegen, Nijmegen, the Netherlands.
Journal of Clinical Oncology (impact factor: 18.37). 12/2002; 20(22):4453-8.
Source: PubMed

ABSTRACT The aims of this prospective study were to investigate the potential role of fluorine-18-deoxyglucose (FDG) positron emission tomography (PET) in determining the efficacy of the local tumor ablative process and to determine the added value of FDG-PET in the detection of tumor recurrence during follow-up.
Twenty-three patients with unresectable colorectal liver metastases were followed up after local ablative therapy consisting of a standard protocol including FDG-PET scanning, computed tomography (CT) scanning, and carcinoembryonic antigen measurements. The mean follow-up period was 16 months (range, 10 to 21 months).
Ninety-six lesions was treated, 56 by local ablative treatment. Within 3 weeks after local ablative treatment, 51 lesions became photopenic on FDG-PET, while five lesions (in five patients) showed persistent activity on FDG-PET. In four of five FDG-PET-positive lesions, a local recurrence developed during follow-up; one FDG-PET-positive lesion turned out to be an abscess. None of the FDG-PET-negative lesions developed a local recurrence during a mean follow-up period of 16 months. During follow-up, 11 patients showed recurrence in the liver outside of the treated area. In all cases, previously negative FDG-PET scans became positive. Extrahepatic recurrence was encountered in nine patients during follow-up; FDG-PET showed all nine cases of tumor recurrence. There was one false-positive FDG-PET caused by an intra-abdominal abscess. In all patients, the time point of detection of recurrence by FDG-PET was considerably earlier than the detection by CT.
FDG-PET seems to have a significant impact in measuring treatment efficacy directly after local ablative therapy. Furthermore, FDG-PET has an added value in patient follow-up because it reveals recurrences earlier than conventional diagnostic modalities.

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Keywords

16 months
 
21 months
 
51 lesions
 
added value
 
carcinoembryonic antigen measurements
 
Extrahepatic recurrence
 
false-positive FDG-PET
 
FDG-PET scanning
 
FDG-PET-negative lesions
 
FDG-PET-positive lesion
 
FDG-PET-positive lesions
 
intra-abdominal abscess
 
local ablative therapy
 
local recurrence
 
negative FDG-PET scans
 
persistent activity
 
potential role
 
prospective study
 
tumor recurrence
 
unresectable colorectal liver metastases