Zhuang H, Sinha P, Pourdehnad M, Duarte P S, Yamamoto A J, Alavi A
Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Nucl Med Commun. 2000 Sep;21(9):793-8. doi: 10.1097/00006231-200009000-00002.
Liver metastasis is a common consequence of colorectal carcinoma. Early and accurate detection of liver metastasis is crucial for a decision about partial hepatectomy, which is considered a standard and potentially curative therapy in such a setting. The presence of extrahepatic metastases will exclude surgical resection as a therapeutic option. Positron emission tomography with fluorine-18-deoxyglucose (FDG-PET) has been successful in detecting and staging a variety of malignancies. The purpose of this study was to assess the utility of FDG-PET in the accurate detection of liver and distal metastases from colorectal cancer. The results of 80 PET and computed tomography (CT) scans were compared with surgical pathology and clinical outcome. FDG-PET detected liver metastases in 28 patients, with a sensitivity of 100%. CT detected metastasis in 20 patients, giving a sensitivity of 71.4%. In addition, in one patient with negative CT findings, PET detected a focus of hypermetabolism in the region adjacent to liver, which was proven to be a second focus of primary colon carcinoma. In six patients with liver metastases, PET correctly detected extrahepatic lesions, while CT only detected hepatic lesions. In conclusion, FDG-PET is an excellent imaging modality for the detection and staging of liver metastases in patients with colorectal carcinomas.
肝转移是结直肠癌的常见后果。早期准确检测肝转移对于决定是否进行部分肝切除术至关重要，在这种情况下，部分肝切除术被视为一种标准的、可能治愈性的治疗方法。存在肝外转移将排除手术切除作为一种治疗选择。氟-18-脱氧葡萄糖正电子发射断层扫描（FDG-PET）已成功用于检测和分期多种恶性肿瘤。本研究的目的是评估FDG-PET在准确检测结直肠癌肝转移和远处转移中的效用。将80例PET和计算机断层扫描（CT）扫描结果与手术病理和临床结果进行比较。FDG-PET检测出28例肝转移患者，敏感性为100%。CT检测出20例转移患者，敏感性为71.4%。此外，在1例CT结果为阴性的患者中，PET在肝脏邻近区域检测到一个高代谢灶，经证实为原发性结肠癌的第二个病灶。在6例肝转移患者中，PET正确检测出肝外病变，而CT仅检测到肝脏病变。总之，FDG-PET是检测和分期结直肠癌患者肝转移的一种优秀的成像方式。
