FDG-PET/CECT Superior to CECT Alone for Early Detection of Recurrence After Colorectal Liver Metastasis Treatment

In a prospective cohort of 64 patients, 18F-FDG-PET/CECT outperformed CECT alone for detecting local tumor progression after thermal ablation (AUC 0.97 vs. 0.73) and resection (AUC 0.96 vs. 0.69) of colorectal liver metastases. PET/CECT also better detected extrahepatic disease.

• Design: Prospective cohort study of 64 patients (154 lesions) scanned 3-5 months post-treatment with thermal ablation or resection.
• Key numbers: For detecting local progression, PET/CECT AUC reached 0.97 post-ablation and 0.96 post-resection, versus 0.73 and 0.69 for CECT alone (p≤0.03). Detection of extrahepatic disease improved from an AUC of 0.79 to 0.91 (p=0.03). CEA had low diagnostic accuracy (AUC 0.60).
• Limitations: Single-center study with a modest sample size examining a specific post-treatment window; results need external validation in broader surveillance protocols.

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