FDG-PET for the pre-operative evaluation of colorectal liver metastases

Eur J Surg Oncol. 2004 Apr;30(3):286-91. doi: 10.1016/j.ejso.2003.10.023.


Introduction: This study assesses the accuracy of routine whole body fluorodeoxyglucose-positron emission tomography (FDG-PET) in the pre-operative staging of patients with colorectal liver metastases (CLM).

Methods: A prospective study of patients referred for hepatic resection was undertaken. Patients were staged by spiral CT and FDG-PET. The results of these investigations were considered independently.

Results: Twenty-eight patients had confirmed CLM. Eleven patients had solitary CLM; 10 of whom were correctly identified by both modalities. In the remaining 17 patients, 10 had multiple CLM and seven had extrahepatic disease. FDG-PET detected all lesions (sensitivity 100%, specificity 91%). CT incorrectly diagnosed solitary CLM in five patients and failed to detect extrahepatic disease in four patients (sensitivity 47%, specificity 91%). FDG-PET resulted in altered management for 12 patients of whom seven avoided inappropriate surgery.

Conclusion: FDG-PET is more sensitive and specific for pre-operative staging of CLM. FDG-PET confers clinical benefit through altered patient management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / diagnostic imaging*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery
  • Female
  • Fluorodeoxyglucose F18*
  • Hepatectomy
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Preoperative Care
  • Prospective Studies
  • Radiopharmaceuticals*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, Emission-Computed / methods*
  • Tomography, Spiral Computed


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18