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Imaging strategies in hepatic metastases from colorectal carcinoma

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Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Approximately two-thirds of metastatic lesions that develop following curative resection of colorectal cancer occur in the liver and lung. In select groups of patients, resection of these lesions is associated with increased 5-year survival. In the liver, precise preoperative documentation of the presence, location, number, and relationship of these lesions to vascular structure is crucial in the selection of candidates for curative resection. Computed tomography with arterial portography (CTAP), intraoperative ultrasonography (IOUS), positron emission tomographic (PET) scan, and radionuclide scanning, including radiolabeled monoclonal antibody imaging, are emerging as the procedures of choice in the preoperative and intraoperative evaluation of metastatic colorectal cancer to the liver.

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References

  1. Galandiuk S, Wieand HS, Moertel CG, Cha SS, Fitzgibbons RJ Jr, Pemberton JH, Wolff BG (1992) Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet 174:27–32

    CAS  PubMed  Google Scholar 

  2. Steele G Jr, Ravikumar TS, Benotti PN (1990) New surgical treatments for recurrent colorectal cancer. Cancer 65:723–730

    PubMed  Google Scholar 

  3. Benjamin IS, Blumgart LH (1988) Hepatic resection for liver metastases. Dig Dis 6:40–51

    CAS  PubMed  Google Scholar 

  4. Hughes KS — Registry of Hepatic Metastases (1988) Resection of the liver for colorectal carcinoma metastases: A multi-institutional study of indications for resection. Surgery 103: 278–288

    Google Scholar 

  5. Steele G Jr, Bleday R, Mayer RJ, Lindblad A, Petrelli N, Weaver D (1991) A prospective evaluation of hepatic resection for colorectal metastases to the liver. J Clin Oncol 9:1105–1112

    PubMed  Google Scholar 

  6. Steele G Jr, Ravikumar TS (1989) Resection of hepatic metastases from colorectal cancer: Biologic perspective. Ann Surg 210:127–138

    PubMed  Google Scholar 

  7. Fortner JG (1988) Recurrence of colorectal cancer after hepatic resection. Am J Surg 155:378–382

    CAS  PubMed  Google Scholar 

  8. Miller DL, Simmons JT, Chang R, Ward BA, Shawker TH, Doppman JL, Chang AE (1987) Hepatic metastasis detection: Comparison of three CT contrast enhancement methods. Radiology 165:785–790

    CAS  PubMed  Google Scholar 

  9. Gunven P, Makuuchi M, Takayasu K, Moriyama N, Yamasaki S, Hasegawa H (1985) Preoperative imaging of liver metastases: Comparison of angiography, CT scan and ultrasonography. Ann Surg 202:573–579

    CAS  PubMed  Google Scholar 

  10. Wernecke K, Rummeny E, Bongartz G, Vassallo P, Kivelitz D, Wiesmann W, Peters PE, Reers B, Reiser M, Pircher W (1991) Detection of hepatic masses in patients with carcinoma: Comparative sensitivities of sonography, CT and MR imaging. AJR 157:731–739

    CAS  PubMed  Google Scholar 

  11. Ohlsson B, Tranberg KG, Lundstedt C, Ekberg H, Hederstrom E (1993) Detection of hepatic metastases in colorectal cancer: A prospective study of laboratory and imaging methods. Eur J Surg 159:275–281

    CAS  PubMed  Google Scholar 

  12. Yamaguchi A, Ishida T, Nishimura G, Kanno M, Kosaka T, Yonemura Y, Izumi R, Miyazaki I, Matsui O (1991) Detection by CT during arterial portography of colorectal cancer metastases to liver. Dis Colon Rectum 34:37–40

    CAS  PubMed  Google Scholar 

  13. Ferrucci JT (1990) Liver tumor imaging: Current concepts. AJR 155:473–484

    CAS  PubMed  Google Scholar 

  14. Parker GA, Lawrence W Jr, Horsley S III, Neifeld JP, Cook D, Walsh J, Brewer W, Koretz MJ (1989) Intraoperative ultrasound of the liver affects operative decision making. Ann Surg 209:569–577

    CAS  PubMed  Google Scholar 

  15. Machi J, Isomoto H, Yamashita Y, Kurohiji T, Shirouzu K, Kakegawa T (1987) Intraoperative ultrasonography in screening for liver metastases from colorectal cancer: Comparative accuracy with traditional procedures. Surgery 101:678–684

    CAS  PubMed  Google Scholar 

  16. Soyer P, Levesque M, Elias D, Zeitoun G, Roche A (1992) Detection of liver metastases from colorectal cancer: Comparison of intraoperative US and CT during arterial portography. Radiology 183:541–544

    CAS  PubMed  Google Scholar 

  17. Boldrini G, deGaetano AM, Giovanni I, Gastagneto M, Colagrande C, Castiglioni G (1987) The systemic use of operative ultrasound for detection of liver metastases during colorectal surgery. World J Surg 11:622–627

    Article  CAS  PubMed  Google Scholar 

  18. Machi J, Isomoto H, Kurohiji T, Shirouzu K, Yamashita Y, Kakegawa T, Sigel B (1986) Detection of unrecognized liver metastases from colorectal cancers by routine use of operative ultrasound. Dis Colon Rectum 29:405–409

    CAS  PubMed  Google Scholar 

  19. Ward BA, Miller DL, Frank JA, Dwyer AJ, Simmons JT, Chang R, Shawker TH, Choyke P, Chang AE (1989) Prospective evaluation of hepatic imaging studies in the detection of colorectal metastases: Correlation with surgical findings. Surgery 105:180–187

    CAS  PubMed  Google Scholar 

  20. Stadler J, Holscher AH, Adolf J (1991) Intraoperative ultrasonographic detection of occult liver metastases in colorectal cancer. Surg Endosc 5:36–40

    Article  CAS  PubMed  Google Scholar 

  21. Charnley RM, Morris DL, Dennison AR, Amar SS, Hardcastle JD (1991) Detection of colorectal liver metastases using intraoperative ultrasonography. Br J Surg 78:45–48

    CAS  PubMed  Google Scholar 

  22. Ravikumar TS, Kane R, Cady B, Jenkins RL, McDermott W, Onik G, Clouse M, Steele G Jr (1987) Hepatic cryosurgery with intraoperative ultrasound monitoring for metastatic colon cancer. Arch Surg 122:403–409

    CAS  PubMed  Google Scholar 

  23. Sugarbaker PH (1990) Surgical decision making for large bowel cancer metastatic to the liver. Radiology 174:621–626

    CAS  PubMed  Google Scholar 

  24. Stewart PJ, Chu JM, Kos SC, Chapuis PH, Bokey EL (1993) Intraoperative ultrasound for the detection of hepatic metastasis from colorectal cancer. Aust NZ J Surg 63:530–534

    CAS  Google Scholar 

  25. Thomas WM, Morris DL, Hardcastle JD (1987) Contact ultrasonography in the detection of liver metastases from colorectal cancer: An in vitro study. Br J Surg 74:955–956

    CAS  PubMed  Google Scholar 

  26. Makuuchi M, Hasegawa H, Yamazaki S, Takayasu K, Moriyama N (1987) The use of operative ultrasound as an aid to liver resection in patients with hepatocellular carcinoma. World J Surg 11:615–621

    Article  CAS  PubMed  Google Scholar 

  27. Makuuchi M, Hasegawa H, Yamazaki S (1987) Four new hepatectomy procedures for resection of the right hepatic vein and preservation of the inferior right hepatic vein. Surg Gynecol Obstet 164:68–72

    CAS  PubMed  Google Scholar 

  28. Bismuth H, Houssin D, Castaing D (1982) Major and minor segmentectomies “re'gle'es” in liver surgery. World J Surg 6:10–24

    CAS  PubMed  Google Scholar 

  29. Charnley RM, Binch C, Morris DL, Hardcastle JD (1988) Visualization of detailed hepatic anatomy by intraoperative ultrasound. Br J Radiol 61:769–770

    Google Scholar 

  30. Charnley RM, Doran J, Morris DL (1989) Cryotherapy for liver metastases: A new approach. Br J Surg 76:1040–1041

    CAS  PubMed  Google Scholar 

  31. Finlay IG, McArdle CS (1986) Occult hepatic metastases in colorectal carcinoma. Br J Surg 73:732–735

    CAS  PubMed  Google Scholar 

  32. Stone MD, Kane R, Bothe A Jr, Jessup M, Cady B, Steele GD Jr (1994) Intraoperative ultrasound imaging of the liver at the time of colorectal cancer resection. Arch Surg 129:431–436

    CAS  PubMed  Google Scholar 

  33. Olsen AK (1990) Intraoperative ultrasonography and the detection of liver metastases in patients with colorectal cancer. Br J Surg 77:998–999

    CAS  PubMed  Google Scholar 

  34. Machi J, Isomoto H, Kurohiji T, Yamashita Y, Shirouzu K, Kakegawa T, Sigel B, Zaren HA, Sariego J (1991) Accuracy of intraoperative ultrasonography in diagnosing liver metastasis from colorectal cancer: Evaluation with postoperative follow-up results. World J Surg 15:551–557

    Article  CAS  PubMed  Google Scholar 

  35. Russo A, Sparacino G, Plaja S, Cajozzo M, LaRosa C, Demma I, Bazan P (1989) Role of intraoperative ultrasound in the screening of liver metastases from colorectal carcinoma: Initial experiences. J Surg Oncol 42:249–255

    CAS  PubMed  Google Scholar 

  36. Castaing RM, Amond J, Kunstlinger F, Bismuth H (1986) Utility of operative ultrasound in the surgical management of live tumors. Ann Surg 204:600–605

    CAS  PubMed  Google Scholar 

  37. Goldenberg DM, Larson SM (1992) Radioimmunodetection in cancer identification. J Nucl Med 33:803–814

    CAS  PubMed  Google Scholar 

  38. Larson SM (1990) Clinical radioimmunodetection, 1978–1988: Overview and suggestions for standardization of clinical trials. Cancer Res 50:92s-898s

    Google Scholar 

  39. Lind P, Lechner P, Arian-Schad K, Klimpfinger M, Cesnik H, Kammerhuber F, Eber O (1991) Anti-carcinoembryonic antigen immunoscintigraphy (Technetium-99m-monoclonal antibody BW 431/26) and serum CEA levels in patients with suspected primary and recurrent colorectal carcinoma. J Mucl Med 32(7): 1319–1325

    CAS  Google Scholar 

  40. Abdel-Nabi H, Doerr RJ, Chan HW, Balu D, Schmelter RF, Maguire RT (1990) In-111 CYT-103 immunoscintigraphy in colorectal carcinoma patients: Safety, sensitivity and preliminary clinical applications. Radiology 175:163–171

    CAS  PubMed  Google Scholar 

  41. Doerr RJ, Abdel-Nabi H, Krag D, Mitchell E (1991) Radiolabeled antibody imaging in the management of colorectal cancer: Results of a multicenter clinical study. Ann Surg 214(2):118–124

    CAS  PubMed  Google Scholar 

  42. Haseman MK, Brown DW, Keeling CA, Reed NL (1992) Radioimmunodetection of occult carcinoembryonic antigen producing cancer. J Nucl Med 33:1750–1757

    CAS  PubMed  Google Scholar 

  43. Divgi CR, McDermott K, Johnson DK, Schnobrich KE, Finn RD, Cohen AM, Larson SM (1991) Detection of hepatic metastases from colorectal carcinoma using Indium-111 (111In) labeled monoclonal antibody (mAb): MSKCC experience with mAb111In-C1110. Int J Rad Appl Instrum [B] 18:705–710

    CAS  Google Scholar 

  44. Abdel-Nabi H, Doerr RJ (1993) Clinical applications of Indium-111 labeled monoclonal antibody imaging in colorectal cancer patients. Semin Nucl Med 13(2):99–113

    Google Scholar 

  45. Yonekura Y, Benua RS, Brill AB, Som P, Yeh SD, Kemeny NE, Fowler JW, MacGregor RR, Stamm R, Christman DR, Wolf AP (1982) Increased accumulation of 2-deoxy-2(18F)-fluoro-D-deoxyglucose in liver metastases from colon carcinoma. J Nucl Med 23:1133–1137

    CAS  PubMed  Google Scholar 

  46. Strauss LG, Conti PS (1991) The applications of PET in clinical oncology. J Nucl Med 32:623–648

    CAS  PubMed  Google Scholar 

  47. Hawkins RA, Choi Y, Huang S-3, Messa C, Hoh C, Phelps ME (1992) Quantitating tumor glucose metabolism with FDG and PET (Editorial). J Nucl Med 33:339–344

    CAS  PubMed  Google Scholar 

  48. Okazumi S, Isono K, Enomoto K, Kikuchi T, Ozaki M, Yamamoto H, Hayashi H, Asanu T, Ryu M (1991) Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET: Characterization of tumor and assessment of effect of treatment. J Nucl Med 33:333–339

    Google Scholar 

  49. American Cancer Society (1991) Cancer facts and figures. American Cancer Society, Atlanta

    Google Scholar 

  50. Seltzer SE, Holman BL (1989) Imaging hepatic metastases from colorectal carcinoma: Identification of candidates for partial hepatectomy. AJR 152:917–923

    CAS  PubMed  Google Scholar 

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Doerr, R.J., Kulaylat, M.N. & Abdel-Nabi, H. Imaging strategies in hepatic metastases from colorectal carcinoma. J Hep Bil Pancr Surg 2, 126–133 (1995). https://doi.org/10.1007/BF02348737

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  • DOI: https://doi.org/10.1007/BF02348737

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