0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Preoperative Positron Emission Tomography to Evaluate Potentially Resectable Hepatic Colorectal Metastases—Invited Critique

Sherry M. Wren, MD
Arch Surg. 2006;141(12):1227. doi:10.1001/archsurg.141.12.1227.
Text Size: A A A
Published online

Extract

This article reports a single institution's experience with PET or PET-CT in patients referred for surgical treatment of hepatic metastases. During a 3-year period, 71 patients who were judged operative candidates by CDMs underwent PET. Detection of hepatic lesions was 100% by CDMs, but PET had only a 90% concordance rate, missing 7 patients' disease. False-negative findings were more likely to be at the dome of the liver or in lesions less than 3 cm in size. Positron emission tomography identified additional disease in 32% of the cases, with more than half of those (13/23) in extra-abdominal locations. The impact of PET on clinical decision making was difficult to fully evaluate. The authors report that a total of 17 patients (24%) had their management altered on the basis of PET findings, but then tack on an additional 8 patients whose PET findings were ignored or further ruled out. The total would then be 25 patients (35%) who may have had their operative decisions altered. The overall rate of false-positive PET findings is difficult to determine because of different false-positive rates depending on whether the PET findings were used in clinical decision making. In the best circumstance, there were no false-positive findings; in contrast there were 6 false-positive findings in the “ignored” group. False upstaging or downstaging rates for PET were 8% and 15%, respectively, and no statistically significant difference was found between PET and PET-CT.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();