NEW YORK (Reuters Health), Aug 17 - Use of F-18 FDG-PET imaging can reduce the rate of futile laparotomies in patients with colorectal liver metastases from 45% to 28%, according to a report in the July issue of the Journal of Nuclear Medicine.
"This is the first and only randomized controlled clinical trial on the efficacy of FDG-PET to select patients with liver metastases from colorectal cancer for liver surgery," senior author Dr. Wim J. G. Oyen, from Radboud University Nijmegen Medical Centre, the Netherlands, told Reuters Health.
"The biggest finding," Dr. Oyen added, "is that FDG-PET detects additional disease that deems liver surgery futile in one in six patients, who would have been taken to surgery when CT alone was used. Furthermore, the addition of FDG-PET in every patient did not result in an increase of overall health care costs."
The results stem from a study of 150 patients with colorectal liver metastases who were randomly assigned to preoperative evaluation with CT alone or combined with FDG-PET. The subjects were followed for at least three years after randomization.
Futile laparotomy, the main outcome measure, was defined as a laparotomy that did not lead to complete tumor removal, showed benign disease, or that did not improve disease-free survival by longer than six months.
Thirty-four patients (45%) in the control group had a futile laparotomy compared with 21 (28%) in the PET group, a risk reduction of 38% (p = 0.042).
"Every patient with liver metastases from colorectal cancer to whom liver surgery is offered, should ask for FDG-PET before the final decision to actually go ahead with liver surgery is made," Dr. Oyen emphasized.
"Future research will focus on the role of neoadjuvant chemotherapy and the role of novel surgical procedures such as radiofrequency ablation of tumors," he added.
By Anthony J. Brown, M.D.
J Nucl Med 2009;50:1036-1041.
Last Updated: 2009-08-17 10:50:04 -0400 (Reuters Health)
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![Overview of the study design. (A) The fully automated deep learning framework was developed to estimate body composition (BC) (defined as subcutaneous adipose tissue [SAT] in liters; visceral adipose tissue [VAT] in liters; skeletal muscle [SM] in liters; SM fat fraction [SMFF] as a percentage; and intramuscular adipose tissue [IMAT] in deciliters) from MRI. The fully automated framework comprised one model (model 1) to quantify different BC measures (SAT, VAT, SM, SMFF, and IMAT) as three-dimensional (3D) measures from whole-body MRI scans. The second model (model 2) was trained to identify standardized anatomic landmarks along the craniocaudal body axis (z coordinate field), which allowed for subdividing the whole-body measures into different subregions typically examined on clinical routine MRI scans (chest, abdomen, and pelvis). (B) BC was quantified from whole-body MRI in over 66,000 individuals from two large population-based cohort studies, the UK Biobank (UKB) (36,317 individuals) and the German National Cohort (NAKO) (30,291 individuals). Bar graphs show age distribution by sex and cohort. BMI = body mass index. (C) After the performance assessment of the fully automated framework, the change in BC measures, distributions, and profiles across age decades were investigated. Age-, sex-, and height-adjusted body composition reference curves were calculated and made publicly available in a web-based z-score calculator (https://circ-ml.github.io).](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/05/body-comp.XgAjTfPj1W.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
