caa a22 4500 445333685 CHVBK 20180317142746.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1670-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-1670-y Preoperative Staging of Patients with Liver Metastases of Colorectal Carcinoma. Does PET/CT Really Add Something to Multidetector CT? [Elektronische Daten] [Emilio Ramos, Carlos Valls, Laura Martinez, Laura Lladó, Jaume Torras, Sandra Ruiz, Cristina Gamez, Teresa Serrano, Joan Fabregat, Antonio Rafecas] Purpose: This study was designed to determine prospectively whether the systematic use of PET/CT associated with conventional techniques could improve the accuracy of staging in patients with liver metastases of colorectal carcinoma. We also assessed the impact on the therapeutic strategy. Methods: Between 2006 and 2008, 97 patients who were evaluated for resection of LMCRC were prospectively enrolled. Preoperative workup included multidetector-CT (MDCT) and PET/CT. In 11 patients with liver steatosis or iodinated contrast allergy, MR also was performed. Sixty-eight patients underwent laparotomy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values for hepatic and extrahepatic staging of MDCT and PET-CT were calculated. Results: In a lesion-by-lesion analysis of the hepatic staging, the sensitivity of MDCT/RM was superior to PET/CT (89.2 vs. 55%, p<0.001). On the extrahepatic staging, PET/CT was superior to MDCT/MR only for the detection of locoregional recurrence (p=0.03) and recurrence in uncommon sites (p=0.016). New findings in PET/CT resulted in a change in therapeutic strategy in 17 patients. However, additional information was correct only in eight cases and wrong in nine patients. Conclusions: PET/CT has a limited role in hepatic staging of LMCRC. Although PET-CT has higher sensitivity for the detection of extrahepatic disease in some anatomic locations, its results are hampered by its low PPV. PET/CT provided additional useful information in 8% of the cases but also incorrect and potentially harmful data in 9% of the staging. Our findings support a more selective use of PET/CT, basically in patients with high risk of local recurrence. Society of Surgical Oncology, 2011 Ramos Emilio Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut Valls Carlos Department of Radiology, Hospital Universitario de Bellvitge, Barcelona, Spain aut Martinez Laura Department of Radiology, Hospital Universitario de Bellvitge, Barcelona, Spain aut Lladó Laura Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut Torras Jaume Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut Ruiz Sandra Department of Radiology, Hospital Universitario de Bellvitge, Barcelona, Spain aut Gamez Cristina PET Unit of the Instituto de Dianóstico por la Imagen (IDI), Barcelona, Spain aut Serrano Teresa Department of Pathology, Hospital Universitario de Bellvitge, Barcelona, Spain aut Fabregat Joan Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut Rafecas Antonio Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2654-2661 1068-9265 18:9<2654 2011 18 10434 https://doi.org/10.1245/s10434-011-1670-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1670-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ramos Emilio Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 700 1- Valls Carlos Department of Radiology, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 700 1- Martinez Laura Department of Radiology, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 700 1- Lladó Laura Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 700 1- Torras Jaume Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 700 1- Ruiz Sandra Department of Radiology, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 700 1- Gamez Cristina PET Unit of the Instituto de Dianóstico por la Imagen (IDI), Barcelona, Spain aut NATIONALLICENCE 700 1- Serrano Teresa Department of Pathology, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 700 1- Fabregat Joan Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 700 1- Rafecas Antonio Department of General Surgery, Hospital Universitario de Bellvitge, Barcelona, Spain aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2654-2661 1068-9265 18:9<2654 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer