Al-Ibraheem Akram, Ruzzeh Saad, Badarneh Mohannad, Al-Adhami Dhuha, Telfah Ahmad
Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, JOR.
School of Medicine, University of Jordan, Amman, JOR.
Cureus. 2023 Dec 31;15(12):e51393. doi: 10.7759/cureus.51393. eCollection 2023 Dec.
Colorectal cancer is a common malignancy, with the liver being the most frequent site of metastases. [F] Fluorodeoxyglucose ([F]FDG) positron emission tomography/computed tomography (PET/CT) has emerged as a valuable tool in detecting and evaluating liver metastases and extrahepatic disease. Herein, we present a case of a 76-year-old male with colorectal cancer associated with lung and liver metastases. The patient received 12 chemoimmunotherapy cycles and was then put on maintenance cetuximab; serial [F]FDG PET/CT scans were utilized to evaluate treatment response. The patient exhibited a positive response to chemoimmunotherapy, with regression of rectal disease and resolution of pulmonary metastatic nodules. Serial [F]FDG PET/CT scans unveiled three distinct necrotic patterns. The case report advocates that [F]FDG PET/CT plays an important role in evaluating colorectal liver metastases (CRLM) response to treatment, identifying transient necrosis, early recurrence, and emphasizing the limitations of post-treatment CT scans in identifying early CRLM recurrence. Integrating functional imaging, particularly [F]FDG PET/CT, promises for management monitoring and surveillance of CRLM patients.
结直肠癌是一种常见的恶性肿瘤，肝脏是最常见的转移部位。[F]氟脱氧葡萄糖（[F]FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）已成为检测和评估肝转移及肝外疾病的重要工具。在此，我们报告一例76岁男性结直肠癌伴肺和肝转移的病例。该患者接受了12个周期的化疗免疫治疗，随后接受西妥昔单抗维持治疗；利用系列[F]FDG PET/CT扫描评估治疗反应。患者对化疗免疫治疗表现出阳性反应，直肠病灶消退，肺转移结节消失。系列[F]FDG PET/CT扫描揭示了三种不同的坏死模式。该病例报告表明，[F]FDG PET/CT在评估结直肠癌肝转移（CRLM）的治疗反应、识别短暂性坏死、早期复发以及强调治疗后CT扫描在识别CRLM早期复发方面的局限性中发挥着重要作用。整合功能成像，尤其是[F]FDG PET/CT，有望用于CRLM患者的管理监测。
