The Value of18F-FDG-PET-CT Imaging in Treatment Evaluation of Colorectal Liver Metastases: A Systematic Review

Okker D. Bijlstra*, Maud M.E. Boreel, Sietse van Mossel, Mark C. Burgmans, Ellen H.W. Kapiteijn, Daniela E. Oprea-Lager, Daphne D.D. Rietbergen, Floris H.P. van Velden, Alexander L. Vahrmeijer, Rutger Jan Swijnenburg, J. Sven D. Mieog, Lioe Fee de Geus-Oei

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
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(1) Background: Up to 50% of patients with colorectal cancer either have synchronous colorectal liver metastases (CRLM) or develop CRLM over the course of their disease. Surgery and thermal ablation are the most common local treatment options of choice. Despite development and improvement in local treatment options, (local) recurrence remains a significant clinical problem. Many different imaging modalities can be used in the follow-up after treatment of CRLM, lacking evidence-based international consensus on the modality of choice. In this systematic review, we evaluated18F-FDG-PET-CT performance after surgical resection, thermal ablation, radioembolization, and neoadjuvant and palliative chemotherapy based on current published literature. (2) Methods: A systematic literature search was performed on the PubMed database. (3) Results: A total of 31 original articles were included in the analysis. Only one suitable study was found describing the role of18F-FDG-PET-CT after surgery, which makes it hard to draw a firm conclusion.18F-FDG-PET-CT showed to be of additional value in the follow-up after thermal ablation, palliative chemotherapy, and radioembolization.18F-FDG-PET-CT was found to be a poor to moderate predictor of pathologic response after neoadjuvant chemotherapy. (4) Conclusions:18F-FDG-PET-CT is superior to conventional morphological imaging modalities in the early detection of residual disease after thermal ablation and in the treatment evaluation and prediction of prognosis during palliative chemotherapy and after radioembolization, and18F-FDG-PET-CT could be considered in selected cases after neoadjuvant chemotherapy and surgical resection.

Original languageEnglish
Article number715
Issue number3
Publication statusPublished - 15 Mar 2022


  • colorectal cancer
  • colorectal liver metastases
  • follow-up
  • positron emission tomography


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