Clinical value of whole-body positron emission tomography in potentially curable colorectal liver metastases

Aims: In selected patients with colorectal liver metastases, hepatic resect ion offers an opportunity for cure, with a 25-38% 5-year survival rate. The aim of this prospective study was to evaluate whether patient selection co uld be improved with pre-operative whole-body 18-fluoro-2-deoxyglucose-posi tron emission tomography (FDG-PET) scan. Methods: Ninety-one consecutive patients were considered to be eligible for liver resection after investigation with conventional diagnostic methods ( CDM). In all these patients a whole-body PET scan with FDG was performed pr ior to surgery. Follow-up was complete with a mean of 23 months (2 weeks-92 months). All PET images were reviewed blinded to intraoperative and follow -up data. Results: PET confirmed liver metastases in 90 (99%) patients, while it prov ided additional information in 10 (11%) patients, i.e. seven intra-abdomina l, and three extra-abdominal. PET falsely upstaged six (6.6%) patients in w hom malignancy was excluded by additional investigation, at the time of sur gery, or during follow-up. PET falsely understaged seven (7.7%) patients wi th small intra-abdominal lesions. Conclusion: In patients with potentially curable colorectal liver metastase s according to conventional diagnostic methods, whole-body FDG-PET can be c onsidered as a complementary examination in order to further select patient s for potentially curative liver resection, and to optimize therapeutic str ategy. (C) 2001 Harcourt Publishers Ltd.