The role of whole-body positron emission tomography with [18F]fluorodeoxyglucose in identifying operable colorectal cancer metastases to the liver

Arch Surg. 1996 Jul;131(7):703-7. doi: 10.1001/archsurg.1996.01430190025007.


Objective: To compare the accuracy of whole-body position emission tomography (PET)using [18F]fluorodeoxyglucose (FDG) with conventional radiological imaging techniques in identifying operable colorectal cancer metastases to the liver.

Design: A double-blind comparative study of FDG-PET as the criterion standard vs conventional radiological imaging methods as the criterion standard, in staging of recurrent colorectal cancer.

Setting: Institutional practice in a tertiary referral center.

Patients: Thirty-four consecutive patients with suspected colorectal cancer metastases recruited for the study between May 1993 and October 1994.

Interventions: Conventional radiological methods of cancer staging included abdominal computed tomography (CT) (n = 34), chest x-rays (n = 15), and chest CT (n = 19) to evaluate extrahepatic disease. Twenty-seven patients were subsequently considered to have apparently isolated cancer metastases to the liver. Anatomical resectability was assessed by magnetic resonance imaging (n = 24) or CT angiography (n = 3) in all study patients. The FDG-PET studies (n = 34) were performed within 8 weeks of conventional radiological imaging.

Main outcome measures: Malignancy of suspected lesions detected by means of FDG-PET and conventional radiological imaging was confirmed by histopathologic examination of resected specimens and percutaneous biopsy specimens and by serial CT scans demonstrating progression of disease.

Results: Unsuspected extrahepatic malignant disease that was missed by conventional radiological imaging was detected by FDG-PET in 11 patients (32%). The PET-detected extrahepatic malignant disease included retroperitoneal nodal metastases (n = 6), pulmonary metastases (n = 3), and locoregional cancer recurrences (n = 2). The additional information afforded by PET consequently had an influence on the clinical management in 10 patients (29%).

Conclusions: The FDG-PET method enabled selection of patients with apparently curable colorectal cancer metastases to the liver for hepatic resection.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Colorectal Neoplasms / pathology*
  • Deoxyglucose / analogs & derivatives*
  • Double-Blind Method
  • Fluorine Radioisotopes*
  • Fluorodeoxyglucose F18
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary*
  • Neoplasm Recurrence, Local
  • Radiography
  • Tomography, Emission-Computed*


  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Deoxyglucose