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Detection of Hepatic Metastases Using Dual-Time-Point FDG PET/CT Scans in Patients with Colorectal Cancer

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Abstract

Purpose

The purpose of this study was to determine the most useful parameter of dual-time-point 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (PET/CT) for detection of hepatic metastases in patients with colorectal cancer.

Procedures

Thirty-nine patients had undergone a dual-time-point PET/CT scan and a subsequent histopathological confirmation for a workup of hepatic metastases. Detection rates were compared for visual analysis score, standardized uptake value (SUV), tumor-to-liver uptake ratio (TLR), and percent changes of the SUV and TLR.

Results

Of 91 liver lesions, 86 lesions were confirmed as metastases. The SUV and TLR of metastatic lesions on the delayed images were higher than those on the first scan (p < 0.001). The signal-to-noise ratio of the delayed PET scan was higher than that of the first scan (p < 0.0001). The TLR and SUV of the delayed scan showed the highest detection rates of 92% and 88%, whereas percent changes of SUV and TLR showed the lowest detection rates (51%, 67%). Visual analysis detected 87% on the delayed scan and 77% on the first scan.

Conclusions

A delayed scan is more favorable for the detection of hepatic metastases of colorectal cancer, and the TLR on the delayed scan was the most useful parameter.

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Acknowledgements

This research was supported by the Pioneer Research Center Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (2010-0002209).

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Jeju National University Hospital, Jeju, Jeju Special Self-Governing Province, South Korea

    Jeong Won Lee

  2. Department of Nuclear Medicine, National Cancer Center Research Institute and Hospital, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea

    Seok-Ki Kim, Sang Mi Lee, Seung Hwan Moon & Tae-Sung Kim

Authors
  1. Jeong Won Lee
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  2. Seok-Ki Kim
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  3. Sang Mi Lee
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Corresponding author

Correspondence to Seok-Ki Kim.

Additional information

Significance:

2-Deoxy-2-[18F]fluoro-d-glucose (FDG) PET has been commonly used for detecting hepatic metastases in patients with colorectal cancer. However, FDG PET has limited detection ability for small-sized liver lesions or low metabolic lesions, which could be explained by the relatively high FDG uptake in normal liver tissue and the variable accumulation of FDG in metastatic lesions. For the improvement of the detection ability, a dual-time-point PET scan was designed and showed the high detection rate of liver tumors in several recent studies. However, it is still not clear which parameter of a dual-time-point scan is the most useful for the clinical identification of hepatic metastases. So, we intended to find the most useful parameter in the clinical use of the dual-time-point FDG PET. The results of our study showed that the tumor-to-liver ratio on the delayed PET scan, rather than the changes of FDG uptake and tumor-to-liver ratio, was the most useful parameter for the detection of hepatic metastases. Further, the delayed PET scan made the detection rate of hepatic metastases and signal-to-noise ratio increase.

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Lee, J.W., Kim, SK., Lee, S.M. et al. Detection of Hepatic Metastases Using Dual-Time-Point FDG PET/CT Scans in Patients with Colorectal Cancer. Mol Imaging Biol 13, 565–572 (2011). https://doi.org/10.1007/s11307-010-0394-x

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  • DOI: https://doi.org/10.1007/s11307-010-0394-x

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