TY - JOUR T1 - Prognostic Ability of <sup>18</sup>F-FDG PET/CT in the Assessment of Colorectal Liver Metastases JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1345 LP - 1351 DO - 10.2967/jnumed.112.102749 VL - 53 IS - 9 AU - Vijayaragavan Muralidharan AU - Marco Kwok AU - Sze Ting Lee AU - Lawrence Lau AU - Andrew M. Scott AU - Christopher Christophi Y1 - 2012/09/01 UR - http://jnm.snmjournals.org/content/53/9/1345.abstract N2 - Modern multidisciplinary therapy for colorectal liver metastases (CRLM) is associated with significant morbidity and must be adapted to the patient’s relative risk. The tools currently available to risk-stratify patients are limited. This study assessed the prognostic utility of metabolic measurements derived from18F-FDG PET compared with previously proposed prognostic scoring systems. Methods: Preoperative 18F-FDG PET/CT studies from a series of 30 patients who underwent liver resection for CRLM after neoadjuvant chemotherapy were evaluated. Quantitative 18F-FDG PET analysis calculated the maximum and mean standardized uptake value, metabolic tumor volume (MTV), and tumor glycolytic volume (TGV) as measures of the metabolic activity of tumors. The predictive value of these parameters was compared with that of 4 prognostic scores developed by Fong, Iwatsuki, Nordlinger, and Rees. Results: High MTV and TGV in patients before metastasectomy were significantly associated with poorer overall survival (MTV: P = 0.001; TGV: P = 0.004) and recurrence-free survival (MTV: P = 0.001, TGV; P = 0.002). Maximum and mean standardized uptake value did not show any significant predictive ability. Of the prognostic scores, prediction of outcome was most accurate using the Basingstoke index (area under the curve, 0.898). Conclusion: Assessment of metabolic tumor burden with volumetric 18F-FDG PET parameters appears to be a valuable adjunct in determining the biology of CRLM before surgical resection and may enable better risk stratification of patients. ER -