STAGING RECURRENT METASTATIC COLORECTAL-CARCINOMA WITH PET

Accurate detection of recurrent colorectal carcinoma remains a diagnos tic challenge, The purposes of this study were to assess the accuracy of (18)FDG-PET in patients with recurrent colorectal carcinoma in dete cting liver metastases compared with computed tomography (CT) and CT p ortography, detecting extrahepatic metastases compared with CT and eva luating the impact on patient management, Methods: Fifty-two patients previously treated for colorectal carcinoma presented on 61 occasions with suspected recurrence and underwent (18)FDG-PET of the entire body , PET, CT and CT portography images were analyzed visually, The final diagnosis was obtained by pathology (n = 44) or clinical and radiologi cal follow-up (n = 17), The impact on management was reviewed retrospe ctively. Results: A total of 166 suspicious lesions were identified. O f the 127 intrahepatic lesions, 104 were malignant, and of the 39 extr ahepatic lesions, 34 were malignant, Fluorine-18-fluorodeoxyglucose im aging was more accurate (92%) than CT and CT portography (78% and 80%, respectively) in detecting liver metastases and more accurate than CT for extrahepatic metastases (92% and 71%, respectively), Fluorine-18- fluorodeoxyglucose detected unsuspected metastases in 17 patients and altered surgical management in 28% of patients, Conclusion: These data identify that (18)FDG-PET is the most accurate noninvasive method for staging patients with recurrent metastatic colorectal carcinoma and p lays an important role in management decisions in this setting.