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Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG-PET-CT.
J Clin Ultrasound. 2008 Jan; 36(1):20-6.JC

Abstract

BACKGROUND

Combined fluorine 18-fluorodeoxyglucose-positron emission tomography-CT imaging has been shown to be of good diagnostic value in the preoperative evaluation of patients with colorectal cancer and liver metastases. The adjunctive use of intraoperative sonography (IOUS) may have a limited impact on treatment selection in these patients.

PURPOSE

To compare the diagnostic performance of preoperative positron emission tomography (PET)-CT alone and PET-CT combined with IOUS in the evaluation of patients who are considered for curative resection of hepatic metastases from colorectal carcinoma.

MATERIALS AND METHODS

Patients with colorectal cancer who underwent resection of hepatic metastases and preoperative PET-CT (with or without contrast-enhanced CT) and IOUS were identified. The performance of the imaging techniques was evaluated through review of the radiologic reports, correlation with surgical and histopathologic findings, and clinical follow-up.

RESULTS

Thirty-one patients (mean age, 63.5 years [range, 53-82 years]) were analyzed. Fifteen patients had received preoperative chemotherapy. The mean interval between PET-CT and IOUS was 22.6 days (range, 1-56 days). In 4 cases, neither PET-CT nor IOUS correctly diagnosed the liver metastases. In all 31 patients, the sensitivity of PET-CT alone and PET-CT combined with IOUS was 63% (95% CI 44-80%) and 93% (95% CI 78-98%), respectively; the positive predictive value was 81% and 89%, respectively. In patients without preoperative chemotherapy (n = 16), the sensitivity of PET-CT alone and PET-CT combined with IOUS was 77% (95% CI 49-94%) and 100% (95% CI 79-100%), respectively. In 11 cases (35%), IOUS altered the surgical strategy.

CONCLUSION

In patients with colorectal carcinoma and potentially resectable liver metastases on preoperative PET-CT, IOUS can provide additional information that may alter decision making with regard to surgical technique.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital of Zurich, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17937421

Citation

Wildi, Stephan M., et al. "Intraoperative Sonography in Patients With Colorectal Cancer and Resectable Liver Metastases On Preoperative FDG-PET-CT." Journal of Clinical Ultrasound : JCU, vol. 36, no. 1, 2008, pp. 20-6.
Wildi SM, Gubler C, Hany T, et al. Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG-PET-CT. J Clin Ultrasound. 2008;36(1):20-6.
Wildi, S. M., Gubler, C., Hany, T., Petrowsky, H., Clavien, P. A., Jochum, W., Gerlach, T., Fried, M., & Mullhaupt, B. (2008). Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG-PET-CT. Journal of Clinical Ultrasound : JCU, 36(1), 20-6.
Wildi SM, et al. Intraoperative Sonography in Patients With Colorectal Cancer and Resectable Liver Metastases On Preoperative FDG-PET-CT. J Clin Ultrasound. 2008;36(1):20-6. PubMed PMID: 17937421.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraoperative sonography in patients with colorectal cancer and resectable liver metastases on preoperative FDG-PET-CT. AU - Wildi,Stephan M, AU - Gubler,Christoph, AU - Hany,Thomas, AU - Petrowsky,Henrik, AU - Clavien,Pierre A, AU - Jochum,Wolfram, AU - Gerlach,Tilman, AU - Fried,Michael, AU - Mullhaupt,Beat, PY - 2007/10/17/pubmed PY - 2008/3/26/medline PY - 2007/10/17/entrez SP - 20 EP - 6 JF - Journal of clinical ultrasound : JCU JO - J Clin Ultrasound VL - 36 IS - 1 N2 - BACKGROUND: Combined fluorine 18-fluorodeoxyglucose-positron emission tomography-CT imaging has been shown to be of good diagnostic value in the preoperative evaluation of patients with colorectal cancer and liver metastases. The adjunctive use of intraoperative sonography (IOUS) may have a limited impact on treatment selection in these patients. PURPOSE: To compare the diagnostic performance of preoperative positron emission tomography (PET)-CT alone and PET-CT combined with IOUS in the evaluation of patients who are considered for curative resection of hepatic metastases from colorectal carcinoma. MATERIALS AND METHODS: Patients with colorectal cancer who underwent resection of hepatic metastases and preoperative PET-CT (with or without contrast-enhanced CT) and IOUS were identified. The performance of the imaging techniques was evaluated through review of the radiologic reports, correlation with surgical and histopathologic findings, and clinical follow-up. RESULTS: Thirty-one patients (mean age, 63.5 years [range, 53-82 years]) were analyzed. Fifteen patients had received preoperative chemotherapy. The mean interval between PET-CT and IOUS was 22.6 days (range, 1-56 days). In 4 cases, neither PET-CT nor IOUS correctly diagnosed the liver metastases. In all 31 patients, the sensitivity of PET-CT alone and PET-CT combined with IOUS was 63% (95% CI 44-80%) and 93% (95% CI 78-98%), respectively; the positive predictive value was 81% and 89%, respectively. In patients without preoperative chemotherapy (n = 16), the sensitivity of PET-CT alone and PET-CT combined with IOUS was 77% (95% CI 49-94%) and 100% (95% CI 79-100%), respectively. In 11 cases (35%), IOUS altered the surgical strategy. CONCLUSION: In patients with colorectal carcinoma and potentially resectable liver metastases on preoperative PET-CT, IOUS can provide additional information that may alter decision making with regard to surgical technique. SN - 0091-2751 UR - https://www.unboundmedicine.com/medline/citation/17937421/Intraoperative_sonography_in_patients_with_colorectal_cancer_and_resectable_liver_metastases_on_preoperative_FDG_PET_CT_ L2 - https://doi.org/10.1002/jcu.20408 DB - PRIME DP - Unbound Medicine ER -