FDG-PET-CT is effective in selecting patients with poor long term survivals for colorectal liver metastases

Are positron emission tomography-computed tomography (PET-CT) scans useful in preoperative assessment of patients with peritoneal disease before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)?

“…In our patient cohort, CT and/or MRI provided adequate information for decision-making in 63.7% (58 out of 91) of the cohort with PET-CT scans performed as adjuncts but PET-CT scans resulted in a change in management in 36.2% (33 out of 91) of our patients, mainly due to the avoidance of unnecessary laparotomies in 16.4% (15 out of 91) of the patients. This is similar to its effect when used for evaluating patients who are considered for liver resection of colorectal liver metastases [17,[25][26][27]. Importantly, all patients who had disease shown on PET-CT went on to have either histologically proven disease or progression of disease on follow-up scans, suggesting that PET-CT has a highly positive-predictive value in our cohort though the formal value was not calculated due to the lack of histopathology in a significant proportion of our patients.…”

Is intraoperative ultrasound still useful for the detection of colorectal cancer liver metastases?

“…Liver MRI is used before surgery by some authors, who argue that its sensitivity in the detection of liver metastases is about 90%. Others advocate the use of preoperative fluorodesoxyglucose positron emission tomography (FDG‐PET) or CT screening before surgery …”

“…Others advocate the use of preoperative fluorodesoxyglucose positron emission tomography (FDG-PET) or CT screening before surgery. 12,13 The present study was conducted to assess the role of IOUS in the management of liver metastasis from colorectal cancer, in an era marked by the frequent use of high-quality, cross-sectional imaging techniques. This single-centre study included all patients who underwent liver resection for CRLM from January 2006 to December 2013 at Nancy-Brabois University Hospital.…”

Value of Pretreatment 18F-fluorodeoxyglucose Positron Emission Tomography in Patients With Localized Pancreatic Cancer Treated With Neoadjuvant Therapy

“…Beyond improvements in staging, PET/CT may provide important insights into tumor biology. The maximum standardized uptake values (SUV) obtained with PET/CT reflect the tumor's glucose metabolism; higher tumor SUV has been correlated with aggressive tumor biology and high grade histology (3,4). Furthermore, decreases in SUV with treatment have been associated with pathologic response and improved overall survival (OS) in esophageal cancer (5,6).…”