Huguet E L, Old S, Praseedom R K, Balan K K, Gibbs P, Jamieson N V
Hepatobiliary and Transplant Unit, Addenbrookes Hospital NHS Trust, Cambridge, UK.
Hepatogastroenterology. 2007 Sep;54(78):1667-71.
BACKGROUND/AIMS: Liver resection is the only treatment which offers long-term survival for patients with colorectal liver metastases. However, the significant mortality and morbidity associated with hepatectomy makes accurate patient selection paramount. Current staging by CT and MRI has limitations, with these modalities delivering a sensitivity and specificity of only 70-80%. Thus some patients may be deprived of long-term survival, and others subjected to futile surgery.
We report our experience of the influence of F18-FDG-PET scanning in the management of 31 consecutive patients with colorectal liver metastases referred for liver resection.
F18-FDG-PET scanning detected liver and pulmonary metastases with a sensitivity of 96% and 100% respectively, in comparison to corresponding figures of 70% and 83% for CT. Furthermore, the sensitivity of F18-FDG-PET scanning in identifying extra-hepatic and extra-pulmonary disease was 100% in comparison to 20% for CT. Overall, F18-FDG-PET scanning resulted in a significant alteration of management in 29% of patients.
F18-FDG-PET scanning has an important clinical impact on the management of patients being considered for resection of colorectal liver metastases.
背景/目的：肝切除术是为结直肠癌肝转移患者提供长期生存机会的唯一治疗方法。然而，肝切除相关的显著死亡率和发病率使得准确选择患者至关重要。目前通过CT和MRI进行的分期存在局限性，这些检查方式的敏感性和特异性仅为70 - 80%。因此，一些患者可能被剥夺了长期生存的机会，而另一些患者则接受了无意义的手术。
我们报告了18F - FDG - PET扫描对31例连续转诊接受肝切除的结直肠癌肝转移患者治疗管理的影响的经验。
18F - FDG - PET扫描检测肝转移和肺转移的敏感性分别为96%和100%，而CT的相应数字分别为70%和83%。此外，18F - FDG - PET扫描识别肝外和肺外疾病的敏感性为100%，而CT为20%。总体而言，18F - FDG - PET扫描导致29%的患者治疗管理发生显著改变。
18F - FDG - PET扫描对考虑行结直肠癌肝转移切除术的患者的治疗管理具有重要的临床影响。
