Timm Denecke MD, Presenter: Nothing to Disclose

Holger Amthauer MD, Abstract Co-Author: Nothing to Disclose

Bert Hildebrandt MD, Abstract Co-Author: Nothing to Disclose

Lukas Lehmkuhl MD, Abstract Co-Author: Nothing to Disclose

Lars HF Stelter MD, Abstract Co-Author: Nothing to Disclose

Christian Stroszczynski PhD, Abstract Co-Author: Nothing to Disclose

Norbert Hosten MD, Abstract Co-Author: Nothing to Disclose

Jens Ricke MD, Abstract Co-Author: Nothing to Disclose

Roland Felix MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

In order to identify patients who may have benefit from local ablative treatment of liver metastases, careful and precise pre-therapeutic evaluation is crucial. Aim of this study was to determine the value of FDG-PET for staging in patients with hepatic metastases of colorectal cancer scheduled for thermal tumor ablation.

68 patients with known hepatic metastases of colorectal cancer referred for MR-guided laser ablation (LITT) were enrolled in this prospective trial. Pre-therapeutic staging consisted of i. v. contrast enhanced CT of the thorax and abdomen, i. v. contrast enhanced MRI of the liver and whole body FDG-PET. Staging and therapy decisions according to the conventional imaging results concerning intra- and extrahepatic disease were compared with therapeutic decisions derived from combined reading of CT, MRI and FDG-PET. Reviewing and decision making were performed by a radiologist, a nuclear medicine specialist and a clinical oncologist in consensus. Long term follow up served as the gold standard.

Out of 215 enhancing lesions detected by FDG-PET, 53 were not detected on other imaging modalities (true positive: n=51, false positive: n=2). In turn 24 lesions visualized on CT and/or MRI were not depicted by FDG-PET (true negative: n=12, false negative n=12). In 30 of 68 cases (44%) FDG-PET revealed additional findings leading to changes of the therapeutic management in 25 cases (37%). Additional intrahepatic findings led to changes in 11 patients, extrahepatic findings in 15. However, in 5 patients false positive and false negative findings on FDG-PET led to an inadequate modification of the therapeutic management.

We found a high additional value of FDG-PET in staging of patients with liver metastases of colorectal cancer compared to CT and MRI. In potential candidates for local ablative therapy with LITT, this results in a relevant impact on the refinement of further treatmant strategy.

Denecke, T, Amthauer, H, Hildebrandt, B, Lehmkuhl, L, Stelter, L, Stroszczynski, C, Hosten, N, Ricke, J, Felix, R, et al, , Evaluation of Patients with Colorectal Cancer for Laser Induced Thermotherapy of Liver Metastases: Impact of FDG-PET on Therapy Decision Making in Comparison to CT and MRI.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4414364.html