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Invited Critique |

Positron Emission Tomography for Colorectal Cancer Liver Metastases: Where”s the Value?  Comment on “Effectiveness of Positron Emission Tomography for Predicting Chemotherapy Response in Colorectal Cancer Liver Metastases”

James C. Hebert, MD
Arch Surg. 2010;145(4):345. doi:10.1001/archsurg.2010.14.
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Advances in chemotherapy during the past decade have created an evolving paradigm for treating patients with liver metastases from colorectal cancer, particularly in increasing the resectability rate.1 The management of disease in these patients relies heavily on imaging with CT and MRI. Positron emission tomography is frequently used. In the preceding article, Glazer et al retrospectively analyzed the utility of PET in the management of disease in these patients. This article is important because it highlights the limitations of PET in predicting response to chemotherapy. Figures 1 and 2 nicely demonstrate the problem. Despite a negative PET finding, viable tumor is likely to be present. The NPV of PET performed within 4 weeks of chemotherapy was 13.3%.

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