False positive PET-CT imaging after application of fibrin-based sponge at the site of previous hepatic resection for colo-rectal metastasis: A short series

Abstract

Surgical resection is the treatment of choice with curative intent for colorectal liver metastasis. Preoperative accurate radiological staging is key for optimal treatment. Fluorine-18 fluorodeoxyglucose PET-CT (PETCT) is effective for this purpose. We present 4 cases of patients with history of hepatectomy for colorectal liver metastasis. In all patients, during the procedure, we used fibrin-based sponge to achieve optimal haemostasis of the parenchymal transection surface. During the oncologic follow-up, a suspicion of disease recurrence justified a staging PET-CT that revealed pathologic metabolic activity on sites of previous liver resection, highly suspicious of tumour recurrence. The delay between hepatectomy and PET-CT for recurrence ranged from 5 to 12 months. In all cases, a new surgical exploration was performed after neoadjuvant chemotherapy, and PET-CT positive sites of previous liver resection were removed. Definitive histological diagnosis showed inflammatory granuloma or fibrous tissue.