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A Pilot Study of Early 18F-FDG PET to Evaluate the Effectiveness of Radiofrequency Ablation of Liver Metastases

Amir H. Khandani1,2, Benjamin F. Calvo2,3, Bert H. O'Neil2,4, Jennifer Jorgenson1,5 and Matthew A. Mauro2,5

1 Section of Nuclear Medicine, Department of Radiology, UNC School of Medicine, CB #7510, Chapel Hill, NC 27599-7510.
2 UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC.
3 Division of Surgical Oncology, Department of Surgery, UNC School of Medicine, Chapel Hill, NC.
4 Division of Hematology–Oncology, Department of Medicine, UNC School of Medicine, Chapel Hill, NC.
5 Section of Vascular and Interventional Radiology, Department of Radiology, UNC School of Medicine, Chapel Hill, NC.


Figure 1
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  		Fig. 1A —72-year-old man with solitary metastasis to liver from ocular malignant melanoma (patient 6 in Table 1). Fluorine-18 FDG PET scan obtained at outside institution before radiofrequency ablation (RFA) shows intense metastasis (arrowhead).

 

Figure 2
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  		Fig. 1B —72-year-old man with solitary metastasis to liver from ocular malignant melanoma (patient 6 in Table 1). Early 18F-FDG PET scan obtained 19 hours after laparoscopic RFA reveals total photopenia at RFA site (arrowhead), which is compatible with complete ablation.

 

Figure 3
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  		Fig. 1C —72-year-old man with solitary metastasis to liver from ocular malignant melanoma (patient 6 in Table 1). Follow-up 18F-FDG PET scans obtained 3 (C), 6 (D), and 9 (E) months after RFA show total photopenia (arrowheads), thus confirming finding in B.

 

Figure 4
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  		Fig. 1D —72-year-old man with solitary metastasis to liver from ocular malignant melanoma (patient 6 in Table 1). Follow-up 18F-FDG PET scans obtained 3 (C), 6 (D), and 9 (E) months after RFA show total photopenia (arrowheads), thus confirming finding in B.

 

Figure 5
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  		Fig. 1E —72-year-old man with solitary metastasis to liver from ocular malignant melanoma (patient 6 in Table 1). Follow-up 18F-FDG PET scans obtained 3 (C), 6 (D), and 9 (E) months after RFA show total photopenia (arrowheads), thus confirming finding in B.

 

Figure 6
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  		Fig. 2A —66-year-old man with solitary metastasis to liver from colorectal cancer (patient 7 in Table 1). Fluorine-18 FDG PET scan obtained before radiofrequency ablation (RFA) shows intense metastasis (arrowhead).

 

Figure 7
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  		Fig. 2B —66-year-old man with solitary metastasis to liver from colorectal cancer (patient 7 in Table 1). Early 18F-FDG PET scan obtained 16 hours after percutaneous RFA reveals focal uptake at RFA site (arrowhead), which is compatible with residual tumor.

 

Figure 8
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  		Fig. 2C —66-year-old man with solitary metastasis to liver from colorectal cancer (patient 7 in Table 1). Follow-up 18F-FDG PET scan obtained 5 months after RFA show increased focal uptake at RFA site (arrowhead), thus confirming finding in B.

 

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