COLORECTAL LIVER METASTASES
FDG PET/CT detected additonal sites of disease in 32 of 75 patients (43%) with colorectal carcinoma liver metastases:
11 patients (15%) upstaged by nodal disease (Figure 1)
20 patients (27%) upstaged due to metastatic disease
1 patient (1%) due to a synchronous malignancy
PET/CT down-staged disease in 3 patients (4%).
There was a change to planned treatment following PET/CT in 14 patients (19%).
CHOLANGIOCARCINOMA
FDG PET/CT detected additional sites of disease in 8 of 23 patients (35%) with cholangiocarcinoma:
1 patient (5%) upstaged by nodal disease
7 patients (30%) upstaged due to metastatic disease (Figure 2)
No patients were downstaged by PET/CT.
There was a change to planned treatment following PET/CT in 3 patients (13%).
GALLBLADDER CARCINOMA
FDG PET/CT detected additonal sites of disease in 5 of 10 patients (50%) with gallbladder carcinoma:
1 patient (10%) upstaged by nodal disease
4 patients (40%) upstaged due to metastatic disease (Figure 3)
No patients were downstaged by PET/CT.
There was a change to planned treatment following PET/CT in 2 patients (20%).
OVERALL PATIENT MANAGEMENT
Overall, PET/CT more accurately staged disease and led to a management change in 17% of patients who may have undergone radical surgical resection using conventional imaging alone.