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Prospective evaluation of CECT and 18F-FDG-PET/CT in detection of hepatic metastases.
Nucl Med Commun. 2009 Feb; 30(2):117-25.NM

Abstract

OBJECTIVES

The purpose of this study was to evaluate the performance of F-fluorodeoxy-D-glucose (FDG)-PET/computed tomography (CT) and contrast-enhanced CT (CECT) in the detection and characterization of hepatic metastases.

METHODS

Forty-five patients harboring an extrahepatic primary malignancy, with suspected hepatic metastases on clinical or ultrasonographic examination were enroled prospectively. Each patient underwent contrast-enhanced abdominal CT and F-FDG-PET/CT within 72 h of each other, reported by an experienced radiologist and nuclear medicine specialist, respectively in a blinded manner. CECT and PET-CT findings were compared and analyzed. Final diagnosis was based on histology and/or follow-up (ranging from 6 to 12 months).

RESULTS

The sensitivity and specificity of CECT in the detection of hepatic metastases was 87.9 and 16.7%, respectively, whereas that of PET/CT was 97 and 75%, respectively. This study showed the superiority of PET/CT over CECT in the detection of hepatic metastases, irrespective of the primary site. This was especially owing to the latter's inability to reliably distinguish small (less than 15 mm) lesions as benign or malignant.

CONCLUSION

Many studies have been conducted on the impact of FDG-PET/CT in the evaluation of hepatic metastases, especially from colorectal primary. Very few prospective studies, however, have been conducted on its role in evaluation of hepatic metastases from nongastrointestinal primaries. Despite its superior performance, it cannot replace CECT for this purpose, owing to the low but definite risk of false positivity based on PET-CT findings alone. Inclusion of CECT in PET/CT protocols may enable us to achieve a higher diagnostic accuracy. This suggests the need for a large prospective study with serial evaluations and pathological correlation.

Authors+Show Affiliations

Department of PET Imaging, Institute of Nuclear Medicine and Allied Sciences, Delhi, India. maria.md@rediffmail.comNo 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)

Evaluation Study
Journal Article

Language

eng

PubMed ID

19057427

Citation

D'souza, Maria Mathew, et al. "Prospective Evaluation of CECT and 18F-FDG-PET/CT in Detection of Hepatic Metastases." Nuclear Medicine Communications, vol. 30, no. 2, 2009, pp. 117-25.
D'souza MM, Sharma R, Mondal A, et al. Prospective evaluation of CECT and 18F-FDG-PET/CT in detection of hepatic metastases. Nucl Med Commun. 2009;30(2):117-25.
D'souza, M. M., Sharma, R., Mondal, A., Jaimini, A., Tripathi, M., Saw, S. K., Singh, D., Mishra, A., & Tripathi, R. P. (2009). Prospective evaluation of CECT and 18F-FDG-PET/CT in detection of hepatic metastases. Nuclear Medicine Communications, 30(2), 117-25. https://doi.org/10.1097/MNM.0b013e32831ec57b
D'souza MM, et al. Prospective Evaluation of CECT and 18F-FDG-PET/CT in Detection of Hepatic Metastases. Nucl Med Commun. 2009;30(2):117-25. PubMed PMID: 19057427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective evaluation of CECT and 18F-FDG-PET/CT in detection of hepatic metastases. AU - D'souza,Maria Mathew, AU - Sharma,Rajnish, AU - Mondal,Anupam, AU - Jaimini,Abhinav, AU - Tripathi,Madhavi, AU - Saw,Sanjiv Kumar, AU - Singh,Dinesh, AU - Mishra,Anil, AU - Tripathi,Rajendra Prasad, PY - 2008/12/6/entrez PY - 2008/12/6/pubmed PY - 2009/3/31/medline SP - 117 EP - 25 JF - Nuclear medicine communications JO - Nucl Med Commun VL - 30 IS - 2 N2 - OBJECTIVES: The purpose of this study was to evaluate the performance of F-fluorodeoxy-D-glucose (FDG)-PET/computed tomography (CT) and contrast-enhanced CT (CECT) in the detection and characterization of hepatic metastases. METHODS: Forty-five patients harboring an extrahepatic primary malignancy, with suspected hepatic metastases on clinical or ultrasonographic examination were enroled prospectively. Each patient underwent contrast-enhanced abdominal CT and F-FDG-PET/CT within 72 h of each other, reported by an experienced radiologist and nuclear medicine specialist, respectively in a blinded manner. CECT and PET-CT findings were compared and analyzed. Final diagnosis was based on histology and/or follow-up (ranging from 6 to 12 months). RESULTS: The sensitivity and specificity of CECT in the detection of hepatic metastases was 87.9 and 16.7%, respectively, whereas that of PET/CT was 97 and 75%, respectively. This study showed the superiority of PET/CT over CECT in the detection of hepatic metastases, irrespective of the primary site. This was especially owing to the latter's inability to reliably distinguish small (less than 15 mm) lesions as benign or malignant. CONCLUSION: Many studies have been conducted on the impact of FDG-PET/CT in the evaluation of hepatic metastases, especially from colorectal primary. Very few prospective studies, however, have been conducted on its role in evaluation of hepatic metastases from nongastrointestinal primaries. Despite its superior performance, it cannot replace CECT for this purpose, owing to the low but definite risk of false positivity based on PET-CT findings alone. Inclusion of CECT in PET/CT protocols may enable us to achieve a higher diagnostic accuracy. This suggests the need for a large prospective study with serial evaluations and pathological correlation. SN - 0143-3636 UR - https://www.unboundmedicine.com/medline/citation/19057427/Prospective_evaluation_of_CECT_and_18F_FDG_PET/CT_in_detection_of_hepatic_metastases_ L2 - https://doi.org/10.1097/MNM.0b013e32831ec57b DB - PRIME DP - Unbound Medicine ER -