Positron Emission Tomography for Staging and Assessment of Tumor Response of Hepatic Malignancies

Robert S. Hellman; Arthur Z. Krasnow; Gary S. Sudakoff

doi:10.1055/s-2006-939838

Seminars in Interventional Radiology, Inhaltsverzeichnis

Semin intervent Radiol 2006; 23(1): 021-032
DOI: 10.1055/s-2006-939838

Positron Emission Tomography for Staging and Assessment of Tumor Response of Hepatic Malignancies

Robert S. Hellman¹ , Arthur Z. Krasnow¹ , Gary S. Sudakoff¹

¹Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin

Abstract

ABSTRACT

¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a useful functional imaging method that complements conventional anatomic imaging modalities for screening patients with colorectal hepatic metastases and hepatocellular cancer to determine their suitability for interventional procedures. FDG PET is more sensitive in detecting colorectal cancer than hepatocellular cancer (~90% versus ~50%). The likelihood of detecting hepatic malignancy with FDG PET rapidly diminishes for lesions smaller than 1 cm. The greatest value of FDG PET in these patients is in excluding extrahepatic disease that might lead to early recurrence after interventional therapy. Promising results have been reported with FDG PET that may show residual (local) or recurrent disease before conventional imaging methods in patients receiving interventional therapy. For patients with colorectal hepatic metastases, many investigators believe that patients with PET evidence of recurrent hepatic disease should receive additional treatment even when there is no confirmatory evidence present on other methodologies. For patients with hepatocellular cancer no conclusions regarding the value of FDG PET for assessment of response to interventional therapy can be reached as there is almost no published data.

KEYWORDS

PET - FDG - colorectal cancer - hepatocellular cancer

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Referenzen

REFERENCES

1 Bos R, van der Hoeven J, van der Wall E et al.. Biologic correlates of 18-fluorodeoxyglucose uptake in human breast cancer measured by positron emission tomography. J Clin Oncol. 2002; 20 379-387
2 Antoch G, Fruedenberg L S, Beyer T et al.. To enhance or not to enhance? 18F-FDG and CT contrast agents in dual-modality 18F-FDG PET/CT. J Nucl Med. 2004; 45 56S-65S
3 Wahl R. Principles of cancer imaging with fluorodeoxy glucose. In: Wahl R, Buchanan J Principles and Practice of Positron Emission Tomography. Philadelphia; Lippincott Williams and Wilkins 2002: 100-110
4 Dimitrakopoulou-Strauss A, Strauss L G, Burger C et al.. Prognostic aspects of 18F-FDG PET kinetics in patients with metastatic colorectal carcinoma receiving FOLFOX chemotherapy. J Nucl Med. 2004; 45 1480-1487
5 Truant S, Huglo D, Hebbar M et al.. Prospective evaluation of the impact of [18F]fluoro-2-deoxy-D-glucose positron emission tomography of respectable colorectal liver metastases. Br J Surg. 2005; 92 362-369
6 Strasberg S M, Dehdashti F, Siegel B A, Drebin J A, Linehan D. Survival of patients evaluated by FDG-PET before hepatic resection for metastatic colorectal carcinoma: a prospective database study. Ann Surg. 2001; 233 293-299
7 Fernandez F G, Drebin J A, Linehan D C et al.. Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET). Ann Surg. 2004; 240 438-450
8 Kinkel K, Lu Y, Both M et al.. Detection of hepatic metastases from cancers of the gastrointestinal tract by using noninvasive imaging methods (US, CT, MR imaging, PET): a meta-analysis. Radiology. 2002; 224 748-756
9 Huebner R H, Park K C, Shepherd J E et al.. A meta-analysis of the literature for whole-body FDG PET detection of recurrent colorectal cancer. J Nucl Med. 2000; 41 1177-1189
10 Lonneux M, Reffad A M, Detry R, Kartheuser A, Gigot J F, Pauwels S. FDG-PET improves the staging and selection of patients with recurrent colorectal cancer. Eur J Nucl Med Mol Imaging. 2002; 29 915-921
11 Kalff V, Hicks R J, Ware R E et al.. The clinical impact of 18F-FDG PET in patients with suspected or confirmed recurrence of colorectal cancer: a prospective study. J Nucl Med. 2002; 43 492-499
12 Whiteford M H, Whiteford H M, Yee L F et al.. Usefulness of FDG-PET scan in the assessment of suspected metastatic or recurrent adenocarcinoma of the colon and rectum. Dis Colon Rectum. 2000; 43 759-767
13 Rohren E M, Paulson E K, Hagge R et al.. The role of F-18 FDG positron emission tomography in preoperative assessment of the liver in patients being considered for curative resection of hepatic metastases from colorectal cancer. Clin Nucl Med. 2002; 27 550-555
14 Rydzewski B, Dehdashti F, Gordon B A, Teefey S A, Strasberg S M, Siegel B A. Usefulness of intraoperative sonography for revealing hepatic metastases from colorectal cancer in patients selected for surgery after undergoing FDG PET. AJR Am J Roentgenol. 2002; 178 353-358
15 Numminen K, Isoniemi H, Halavaara J et al.. Preoperative assessment of focal liver lesions: multidetector computed tomography challenges magnetic resonance imaging. Acta Radiol. 2005; 46 9-15
16 Selzner M, Hany T F, Wildbrett P et al.. Does the novel PET/CT imaging modality impact on the treatment of patients with metastatic colorectal cancer of the liver?. Ann Surg. 2004; 240 1027-1036
17 Hussain S M, Zondervan P E, Ijzermans J NM et al.. Benign versus malignant hepatic nodules: MR imaging findings with pathologic correlation. Radiographics. 2002; 22 1023-1039
18 Okazumi S, Isono K, Enomoto K et al.. Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET: characterization of tumor and assessment of effect of treatment. J Nucl Med. 1992; 33 333-339
19 Ho C, Yu S CH, Yeung D WC. 11C-acetate PET imaging in hepatocellular carcinoma and other liver masses. J Nucl Med. 2003; 44 213-221
20 Khan M A, Combs C S, Brunt E M et al.. Positron emission tomography scanning in the evaluation of hepatocellular carcinoma. J Hepatol. 2000; 32 792-797
21 Wudel L J, Delbeke D, Morris D et al.. The role of [18F]fluorodeoxyglucose positron emission tomography imaging in the evaluation of hepatocellular carcinoma. Am Surg. 2003; 69 117-126
22 Shiomi S, Hishiguchi S, Ishizu H et al.. Usefulness of positron emission tomography with fluorine-18-fluorodeoxyglucose for predicting outcome in patients with hepatocellular carcinoma. Am J Gastroenterol. 2001; 96 1877-1880
23 Lee J D, Yun M, Lee J M et al.. Analysis of gene expression profiles of hepatocellular carcinomas with regard to 18F-fluorodeoxyglucose uptake pattern on positron emission tomography. Eur J Nucl Med Mol Imaging. 2004; 31 1621-1630
24 Rose A T, Rose D M, Pinson C W et al.. Hepatocellular carcinoma outcomes based on indicated treatment strategy. Am Surg. 1998; 64 1128-1134
25 Sugiyama M, Sakahara H, Torizuka T et al.. 18F-FDG PET in the detection of extrahepatic metastases from hepatocellular carcinoma. J Gastroenterol. 2004; 39 961-968
26 Ruers T, Bleichrodt R P. Treatment of liver metastases, an update on the possibilities and results. Eur J Cancer. 2002; 38 1023-1033
27 Kostakoglu L, Goldsmith S J. 18F-FDG PET evaluation of the response to therapy for lymphoma and for breast, lung, and colorectal carcinoma. J Nucl Med. 2003; 44 224-239
28 Delbeke D, Martin W H. PET and PET-CT for evaluation of colorectal carcinoma. Semin Nucl Med. 2004; 34 209-223
29 Antoch G, Vogt F M, Veit P et al.. Assessment of liver tissue after radiofrequency ablation: findings with different imaging procedures. J Nucl Med. 2005; 46 520-525
30 Vitola J V, Delbeke D, Meranze S G et al.. Positron emission tomography with F-18-fluorodeoxyglucose to evaluate the results of hepatic chemoembolization. Cancer. 1996; 78 2216-2222
31 Langenhoff B S, Oyen W JG, Jager G J et al.. Efficacy of fluorine-18-deoxyglucose positron emission tomography in detecting tumor recurrence after local ablative therapy for liver metastases: a prospective study. J Clin Oncol. 2002; 20 4453-4458
32 Blokhuis T J, van der Schaaf M C, van den Tol M P et al.. Results of radio frequency ablation of primary and secondary liver tumors: long-term follow-up with computed tomography and positron emission tomography-18F-deoxyfluroglucose scanning. Scand J Gastroenterol Suppl. 2004; 241 93-97
33 Anderson G S, Brinkman F, Soulen M C et al.. FDG positron emission tomography in the surveillance of hepatic tumors treated with radiofrequency ablation. Clin Nucl Med. 2003; 28 192-197
34 Wong C Y, Salem R, Raman S, Gates V L, Dworkin H J. Evaluating 90Y-glass microsphere treatment response of unresectable colorectal liver metastases by [18F]FDG PET: a comparison with CT or MRI. Eur J Nucl Med Mol Imaging. 2002; 29 815-820
35 Wong C Y, Salem R, Quing F et al.. Metabolic response after intraarterial 90Y-glass microsphere treatment for colorectal liver metastases: comparison of quantitative and visual analyses by 18F-FDG PET. J Nucl Med. 2004; 45 1892-1897
36 Popperl G, Helmberger T, Munzing W et al.. Selective internal radiation therapy with SIR-Spheres in patients with nonresectable liver tumors. Cancer Biother Radiopharm. 2005; 20 200-208
37 Torizuka T, Tamaki N, Inokuma T et al.. Value of fluorine-18-PET to monitor hepatocellular carcinoma after interventional therapy. J Nucl Med. 1994; 35 1965-1969

Robert S HellmanM.D.

Nuclear Medicine, Froedtert Hospital

9200 W. Wisconsin Avenue, Milwaukee, WI 53226