Can PET–CT with FDG replace contrast enhanced CT for imaging of liver metastases?

Excerpt

Liver is a common site of metastatic spread of different primary tumours and a non-invasive detection of liver metastases is a clinical challenge. In particular, in colorectal cancer, the liver is often the first site of metastatic disease and may be the only site of spread in as many as 30–40% of the patients with advanced disease [1]. Colorectal carcinoma is the third most common solid tumour and ranks second as a cause of death because of neoplasia in the Western world [2]. The overall 5-year survival rate is approximately 60% and differs for each stage. For Dukes A (tumours involving only the mucosa) the 5-year survival rate exceeds 90%, whereas for metastatic colorectal cancer is about 5%, with liver metastases being the main cause of death in these patients [3]. Approximately 20% of those patients have synchronous liver metastases and 25% develop metachronous liver metastases. The accurate and early diagnosis of liver metastases has an impact on the overall survival because of the possibility of surgical resection in an early stage and if the tumour is confined to liver. …