PET/CT May Improve Detection of Local CRC Liver Metastasis Progression

The combined imaging approach improved detection of local recurrence and extrahepatic disease during early posttreatment follow‐up for colorectal liver metastases.

By
Andrea Surnit
August 12, 2026
3 min

MDSpire News

Objective:

To evaluate the effectiveness of fluorine-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) combined with contrast-enhanced computed tomography (CECT) in detecting local tumor progression after treatment for colorectal liver metastases.

Approach:

Study Design: A single-center prospective observational cohort study involving 64 patients with 154 colorectal liver metastases treated with thermal ablation, hepatic resection, or both.
Follow-Up: Patients underwent CECT, carcinoembryonic antigen (CEA) testing, and F-18 FDG PET/CECT 3 to 5 months post-treatment.
Disease Progression Assessment: Disease progression was confirmed through histopathology, multidisciplinary team consensus, or extended follow-up of up to 3 years.

Key Findings:

66% of patients showed disease progression at first follow-up.
Local tumor progression was identified in 25% of patients.
F-18 FDG PET/CECT demonstrated greater diagnostic accuracy for local tumor progression compared to CECT alone.
F-18 FDG PET/CECT identified all cases of local tumor progression, while CECT detected fewer than half.
F-18 FDG PET/CECT was more accurate in identifying extrahepatic disease compared to CECT.
CEA testing had a 43% false-negative rate for disease progression.

Interpretation:

Adding F-18 FDG PET/CT to standard care improved detection of local tumor progression and was more accurate for identifying extrahepatic disease, but did not enhance detection of new colorectal liver metastases.

Limitations:

Single-center design.
Relatively small and heterogeneous treatment groups.
Potential selection bias.
Reliance on multidisciplinary consensus rather than histopathologic confirmation for most diagnoses.