Positron emission tomography to stage suspected metastatic colorectal carcinoma to the liver

Am J Surg. 1996 Jan;171(1):21-6. doi: 10.1016/S0002-9610(99)80067-1.


Background: Accurate detection of recurrent colorectal carcinoma remains a clinical challenge. Positron emission tomography (PET) using 18F-fluorodeoxyglucose (18FDG) is an imaging technique that allows direct evaluation of cellular metabolism. 18F-fluorodeoxyglucose PET was compared to computed tomography (CT) and CT portography for staging metastatic colorectal carcinoma.

Patients and methods: Twenty-four patients previously treated for colorectal carcinoma who had suspected recurrence to the liver underwent an 18FDG PET scan of the entire body. All patients had either a CT scan of the abdomen (n = 17), a CT portogram (n = 18), or both (n = 11). The final diagnosis was obtained by tissue pathology in 19 patients and clinical follow-up in 5 patients.

Results: A total of 60 suspicious lesions were identified. Of the 55 intrahepatic lesions, 39 were malignant and 16 were benign. Of the 5 extra-hepatic lesions, 4 were malignant. The 18FDG PET imaging had a higher accuracy (93%) than CT and CT portography (both 76%) in detecting metastatic disease to the liver, and detected unsuspected extrahepatic recurrence in 4 patients. Although the sensitivity of 18FDG PET (90%) was slightly lower than that of CT portography (97%), the specificity was much higher (100% versus 9%), including postsurgical sites. 18FDG PET altered surgical plans in 6 (25%) of 24 patients.

Conclusions: 18FDG PET is extremely useful in staging patients with suspected metastatic colorectal carcinoma to the liver.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Colorectal Neoplasms / pathology*
  • Deoxyglucose / analogs & derivatives
  • Female
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Staging / methods*
  • Sensitivity and Specificity
  • Tomography, Emission-Computed*
  • Tomography, X-Ray Computed


  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Deoxyglucose