Unlike many others, this study population included patients with and without previous treatment. We can assume it is large enough to give a genuine hypothesis.
This is not a particularly large sample size but it should be noted that it was obtained from a single hospital site over a period of 20 months.
The patients’ had a known diagnosis of liver metastases from present or previous colorectal cancer and were eligible for resection or ablation treatment. The study population of 80 (76 but 4 participated twice) was carefully selected to ensure they met set criteria. The author recommends MRI for all patients diagnosed with CRLM after CE-CT to aid in MDT treatment planning, for patients unable to have a MRI they recommend PET/CT. The results found MRI to have a higher sensitivity than both CT and PET/CT, though the specificity of all three was similar (see table 1). (2018) performed a recent study comparing the accuracy of CE-CT, MRI and PET/CT in detecting CRLM in patients considered for treatment. The blog will compare the various modalities available to investigate CRLM. Modalities used to investigate liver metastases include CT, ultrasound (US), magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT). Accurate diagnostic imaging is imperative in making this decision. The number, size and location of the metastases influence the choice of treatment (NICE, 2014). Treatments include chemotherapy, radiotherapy and thermal ablation. It is possible to cure liver metastases using surgical resection but if patients are unsuitable candidates for surgery alternative treatment methods must be considered. To do this they may require further imaging of the liver. If metastases are only localised to the liver it is recommended that a multidisciplinary team (MDT) decide on a course of treatment. The National Institute for Health and Care Excellence (NICE) recommends a contrast enhanced computed tomography (CE-CT) scan of the chest, abdomen and pelvis to assess metastatic disease. The liver is the most common location of metastases from colorectal cancer (CRC). This blog will focus specifically on colorectal liver metastases (CRLM). Many types of primary tumours metastasise to the liver. (Bickle) Image courtesy of Dr Ian Bickle, : 53536.
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