Imaging in resectable colorectal liver metastasis patients with or without preoperative chemotherapy: Results of the PROMETEO-01 study

F. L. Rojas Llimpe, F. Di Fabio, G. Ercolani, E. Giampalma, A. Cappelli, C. Serra, P. Castellucci, A. D'Errico, R. Golfieri, A. D. Pinna, C. Pinto

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Abstract

Background:The aim of the PROMETEO-01 Study was to define the diagnostic accuracy of imaging techniques in colorectal cancer liver metastasis (CRCLM) patients. Methods:Patients referred to Bologna S. Orsola-Malpighi Hospital performed a computed-tomography scan (CT), magnetic resonance (MR), 18F-FDG-PET/CTscan (PET/CT) and liver contrast-enhanced-ultrasound (CEUS); CEUS was also performed intraoperatively (i-CEUS). Every pathological lesion was compared with imaging data.Results:From December 2007 to August 2010, 84 patients were enrolled. A total of 51 (60.71%) resected patients were eligible for analysis. In the lesion-by-lesion analysis 175 resected lesions were evaluated: 67(38.3%) belonged to upfront resected patients (group-A) and 108 (61.7%) to chemotherapy-pretreated patients (group-B). In all patients the sensitivity of MR proved better than CT (91% vs 82%; P=0.002), CEUS (91 vs 81%; P=0.008) and PET/CT (91% vs 60%; P=0.000), whereas PET/CT showed the lowest sensitivity. In group-A the sensitivity of i-CEUS, MR, CT, CEUS and PET/CT was 98%, 94%, 91%, 84% and 78%, respectively. In group-B the i-CEUS proved equivalent in sensitivity to MR (95% and 90%, respectively, P=0.227) and both were significantly more sensitive than other procedures. The CT sensitivity in group-B was lower than in group-A (77% vs 91%, P=0.024).Conclusions:A thoraco-abdominal CT provides an adequate baseline evaluation and guides judgment as to the resectability of CRCLM patients. In the subset of candidates for induction chemotherapy to increase the chance of liver resection, the most rational approach is to add MR for the staging and restaging of CRCLM.

Original languageEnglish
Pages (from-to)667-673
Number of pages7
JournalBritish Journal of Cancer
Volume111
Issue number4
DOIs
Publication statusPublished - Aug 12 2014

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Tomography
Neoplasm Metastasis
Drug Therapy
Liver
Magnetic Resonance Spectroscopy
Liver Neoplasms
Colorectal Neoplasms
Contrast Sensitivity
Induction Chemotherapy
Fluorodeoxyglucose F18
Diagnostic Imaging

Keywords

  • chemotherapy
  • colorectal cancer
  • imaging
  • liver metastasis
  • surgery

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Imaging in resectable colorectal liver metastasis patients with or without preoperative chemotherapy : Results of the PROMETEO-01 study. / Rojas Llimpe, F. L.; Di Fabio, F.; Ercolani, G.; Giampalma, E.; Cappelli, A.; Serra, C.; Castellucci, P.; D'Errico, A.; Golfieri, R.; Pinna, A. D.; Pinto, C.

In: British Journal of Cancer, Vol. 111, No. 4, 12.08.2014, p. 667-673.

Research output: Contribution to journalArticle

Rojas Llimpe, FL, Di Fabio, F, Ercolani, G, Giampalma, E, Cappelli, A, Serra, C, Castellucci, P, D'Errico, A, Golfieri, R, Pinna, AD & Pinto, C 2014, 'Imaging in resectable colorectal liver metastasis patients with or without preoperative chemotherapy: Results of the PROMETEO-01 study', British Journal of Cancer, vol. 111, no. 4, pp. 667-673. https://doi.org/10.1038/bjc.2014.351
Rojas Llimpe, F. L. ; Di Fabio, F. ; Ercolani, G. ; Giampalma, E. ; Cappelli, A. ; Serra, C. ; Castellucci, P. ; D'Errico, A. ; Golfieri, R. ; Pinna, A. D. ; Pinto, C. / Imaging in resectable colorectal liver metastasis patients with or without preoperative chemotherapy : Results of the PROMETEO-01 study. In: British Journal of Cancer. 2014 ; Vol. 111, No. 4. pp. 667-673.
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abstract = "Background:The aim of the PROMETEO-01 Study was to define the diagnostic accuracy of imaging techniques in colorectal cancer liver metastasis (CRCLM) patients. Methods:Patients referred to Bologna S. Orsola-Malpighi Hospital performed a computed-tomography scan (CT), magnetic resonance (MR), 18F-FDG-PET/CTscan (PET/CT) and liver contrast-enhanced-ultrasound (CEUS); CEUS was also performed intraoperatively (i-CEUS). Every pathological lesion was compared with imaging data.Results:From December 2007 to August 2010, 84 patients were enrolled. A total of 51 (60.71{\%}) resected patients were eligible for analysis. In the lesion-by-lesion analysis 175 resected lesions were evaluated: 67(38.3{\%}) belonged to upfront resected patients (group-A) and 108 (61.7{\%}) to chemotherapy-pretreated patients (group-B). In all patients the sensitivity of MR proved better than CT (91{\%} vs 82{\%}; P=0.002), CEUS (91 vs 81{\%}; P=0.008) and PET/CT (91{\%} vs 60{\%}; P=0.000), whereas PET/CT showed the lowest sensitivity. In group-A the sensitivity of i-CEUS, MR, CT, CEUS and PET/CT was 98{\%}, 94{\%}, 91{\%}, 84{\%} and 78{\%}, respectively. In group-B the i-CEUS proved equivalent in sensitivity to MR (95{\%} and 90{\%}, respectively, P=0.227) and both were significantly more sensitive than other procedures. The CT sensitivity in group-B was lower than in group-A (77{\%} vs 91{\%}, P=0.024).Conclusions:A thoraco-abdominal CT provides an adequate baseline evaluation and guides judgment as to the resectability of CRCLM patients. In the subset of candidates for induction chemotherapy to increase the chance of liver resection, the most rational approach is to add MR for the staging and restaging of CRCLM.",
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T1 - Imaging in resectable colorectal liver metastasis patients with or without preoperative chemotherapy

T2 - Results of the PROMETEO-01 study

AU - Rojas Llimpe, F. L.

AU - Di Fabio, F.

AU - Ercolani, G.

AU - Giampalma, E.

AU - Cappelli, A.

AU - Serra, C.

AU - Castellucci, P.

AU - D'Errico, A.

AU - Golfieri, R.

AU - Pinna, A. D.

AU - Pinto, C.

PY - 2014/8/12

Y1 - 2014/8/12

N2 - Background:The aim of the PROMETEO-01 Study was to define the diagnostic accuracy of imaging techniques in colorectal cancer liver metastasis (CRCLM) patients. Methods:Patients referred to Bologna S. Orsola-Malpighi Hospital performed a computed-tomography scan (CT), magnetic resonance (MR), 18F-FDG-PET/CTscan (PET/CT) and liver contrast-enhanced-ultrasound (CEUS); CEUS was also performed intraoperatively (i-CEUS). Every pathological lesion was compared with imaging data.Results:From December 2007 to August 2010, 84 patients were enrolled. A total of 51 (60.71%) resected patients were eligible for analysis. In the lesion-by-lesion analysis 175 resected lesions were evaluated: 67(38.3%) belonged to upfront resected patients (group-A) and 108 (61.7%) to chemotherapy-pretreated patients (group-B). In all patients the sensitivity of MR proved better than CT (91% vs 82%; P=0.002), CEUS (91 vs 81%; P=0.008) and PET/CT (91% vs 60%; P=0.000), whereas PET/CT showed the lowest sensitivity. In group-A the sensitivity of i-CEUS, MR, CT, CEUS and PET/CT was 98%, 94%, 91%, 84% and 78%, respectively. In group-B the i-CEUS proved equivalent in sensitivity to MR (95% and 90%, respectively, P=0.227) and both were significantly more sensitive than other procedures. The CT sensitivity in group-B was lower than in group-A (77% vs 91%, P=0.024).Conclusions:A thoraco-abdominal CT provides an adequate baseline evaluation and guides judgment as to the resectability of CRCLM patients. In the subset of candidates for induction chemotherapy to increase the chance of liver resection, the most rational approach is to add MR for the staging and restaging of CRCLM.

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KW - colorectal cancer

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KW - liver metastasis

KW - surgery

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