Hiroshi Kodama, Presenter: Nothing to Disclose

Koichiro Yamakado MD, PhD, Abstract Co-Author: Nothing to Disclose

Haruyuki Takaki MD, Abstract Co-Author: Nothing to Disclose

Masataka Kashima MD, Abstract Co-Author: Nothing to Disclose

Junji Uraki MD, Abstract Co-Author: Nothing to Disclose

Atsuhiro Nakatsuka MD, Abstract Co-Author: Nothing to Disclose

Takashi Yamanaka MD, Abstract Co-Author: Nothing to Disclose

Kan Takeda MD, Abstract Co-Author: Nothing to Disclose

To retrospectively evaluate the clinical impact of pretreatment 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT on treatment strategy in patients who plan to receive lung radiofrequency (RF) ablation for the treatment of colorectal cancer (CRC) lung metastases.

Between September 2005 and February 2011, 85 consecutive patients were referred to our hospital to receive lung radiofrequency (RF) ablation for CRC lung metastases and underwent PET/CT examination for pre-treatment work up. The incidence of unexpected lesions detected by PET/CT and that of changing treatment strategy were evaluated. Factors linked with detection of unexpected lesions were also evaluated by multiple logistic regression analysis.

Out of 85 patients, unexpected lesions were detected in 19 patients (22.4%, 19/85). They were intra-pelvic or thoracic nodal metastasis (n=6), local recurrence of primary tumor (n=5), liver metastasis (n=3), peritoneal dissemination (n=2), and bone metastasis (n=1), trachea metastasis (n=1), and second primary colon cancer (n=1). Treatment strategy was changed in 16 patients (18.8%, 16/85) in whom unexpected lesions were detected. Lung RF ablation was canceled in 9 patients (10.6%, 9/85). Another treatment including liver RF ablation, endoscopic treatment and/or chemotherapy was added following lung RF ablation in the other 7 patients. The elevating carcinoembryonic antigen (CEA) level (>6.0ng/ml) was the only predictor significantly linked with unexpected lesion in the multivariate analysis.

PET/CT study should be performed in patients with CRC lung metastasis who plan to receive lung RF ablation, in particular, when the CEA level is high.

PET/CT study should be performed in patients with CRC lung metastasis who plan to receive lung RF ablation, in particular, when the CEA level is high.

Kodama, H, Yamakado, K, Takaki, H, Kashima, M, Uraki, J, Nakatsuka, A, Yamanaka, T, Takeda, K, Impact of FDG-PET/CT on Treatment Strategy in Colorectal Cancer Lung Metastasis before Lung Radiofrequency Ablation.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005591.html