TY - JOUR
T1 - Multidetector computed tomography follow-up of hypoattenuating small liver lesions in patients with rectal cancer
AU - Tan, Cher Heng
AU - Bhosale, Priya R.
AU - Das, Prajnan
AU - Crane, Christopher H.
AU - Viswanathan, Chitra
AU - Raval, Bharat
AU - Eng, Cathy
AU - Iyer, Revathy B.
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2011/8
Y1 - 2011/8
N2 - Objective: To study the behavior of hypoattenuating liver lesions, deemed too small to characterize at baseline scanning with multidetector computed tomography (CT), in patients with rectal cancer. Methods: Retrospective review of locally advanced rectal cancer patients from a radiation oncology therapy database was conducted. Patients who presented before neoadjuvant chemoradiation without metastases at baseline CT and with follow-up scans for at least 1 year after therapy were evaluated. CT studies were reviewed for the presence and change in size of hypoattenuating liver lesions (<15 mm) at baseline and follow-up. Results: A total of 616 consecutive patients from the radiotherapy database were reviewed. Of these, 70 patients with a total of 163 hepatic lesions met the selection criteria. The mean patient age was 62.4 years (range, 26-85 years). All patients subsequently underwent surgery and adjuvant chemotherapy. The mean time of radiographic imaging from baseline CT to most recent surveillance CT was 3.3 years (range, 1.1-7.4 years). Two radiologists independently reviewed the CTs. The lesions were stable in 56 of 70 (80.0%, 95% confidence interval: 69%, 89%) patients. Of 163 lesions, 148 (90.8%) were stable, 8 (4.9%) regressed, and 7 (4.3%) progressed in size. No significant difference in results was found for patients stratified according to T-stage (P = 0.41) and N-stage (P > 0.99). Conclusion: In patients with rectal cancer, majority of small hypoattenuating liver lesions remain stable and are treated as benign lesions, at multidetector CT follow-up of more than a year. Nevertheless, hepatic lesion stability during systemic therapy should still be interpreted with caution and closely followed for at least 1 year after completion of therapy.
AB - Objective: To study the behavior of hypoattenuating liver lesions, deemed too small to characterize at baseline scanning with multidetector computed tomography (CT), in patients with rectal cancer. Methods: Retrospective review of locally advanced rectal cancer patients from a radiation oncology therapy database was conducted. Patients who presented before neoadjuvant chemoradiation without metastases at baseline CT and with follow-up scans for at least 1 year after therapy were evaluated. CT studies were reviewed for the presence and change in size of hypoattenuating liver lesions (<15 mm) at baseline and follow-up. Results: A total of 616 consecutive patients from the radiotherapy database were reviewed. Of these, 70 patients with a total of 163 hepatic lesions met the selection criteria. The mean patient age was 62.4 years (range, 26-85 years). All patients subsequently underwent surgery and adjuvant chemotherapy. The mean time of radiographic imaging from baseline CT to most recent surveillance CT was 3.3 years (range, 1.1-7.4 years). Two radiologists independently reviewed the CTs. The lesions were stable in 56 of 70 (80.0%, 95% confidence interval: 69%, 89%) patients. Of 163 lesions, 148 (90.8%) were stable, 8 (4.9%) regressed, and 7 (4.3%) progressed in size. No significant difference in results was found for patients stratified according to T-stage (P = 0.41) and N-stage (P > 0.99). Conclusion: In patients with rectal cancer, majority of small hypoattenuating liver lesions remain stable and are treated as benign lesions, at multidetector CT follow-up of more than a year. Nevertheless, hepatic lesion stability during systemic therapy should still be interpreted with caution and closely followed for at least 1 year after completion of therapy.
KW - computed tomography
KW - liver metastases
KW - rectal cancer
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U2 - 10.1097/COC.0b013e3181e84e1a
DO - 10.1097/COC.0b013e3181e84e1a
M3 - Article
C2 - 20686401
AN - SCOPUS:79961171085
SN - 0277-3732
VL - 34
SP - 411
EP - 416
JO - American Journal of Clinical Oncology: Cancer Clinical Trials
JF - American Journal of Clinical Oncology: Cancer Clinical Trials
IS - 4
ER -