Abstract:

Between May 2005 and March 2007, catheter-port systems were placed in 20 pts for continuous hepatic artery infusion chemotherapy in the treatment of unresectable colorectal liver metastases. Carboplatin (or oxaliplatin) plus 5-fluorouracil and systemic leucovorin were administered. No complications occurred during the implantation procedures. The mean number of intrahepatic chemotherapy cycles per patient was 10 (4-25). The mean follow-up period was 412 (100-853) days. During the follow-up period, complications occurred in 9 patients (45%), but surgical or interventional radiological correction was successful in all but one case. At present, 14 patients are alive within 4 and 41 months and continue to receive intraarterial chemotherapy, while 6 patients died in 5 to 21 months from tumor progression. The common 1 -year survival is 90% (18 patients). Percutaneous implantation is potentially effective treatment for patients with CLM.

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Abstract:

Purpose. Was to evaluate possibilities of FDCTA as a method of colorectal liver metastases (CLM) detection and differentional diagnostics.

Materials and methods. FD-CT-A was performed to examine 41 patients. Patients with lobe CLM (n =15) were included into the 1-st group. Purpose was to exclude metastatic lesions of contralateral lobe before surgical treatment. Patients with bilobar metastatic spread (n = 26) were included into the 2-nd group. Purpose was to detect metastases before and during regional therapy. Scanning was performed on the hybryde angiographic system Innova-4100 «GЕ Нealthcare, USA» with 5 sec scanning time, fov 23 × 23 cm, delay from 10 to 22 sec during hepatic arteriography 15–40 ml Ultravist-370 «Bayer Schering Pharma, Germany» with rate 2–4 ml/sec.

Results. In the first group 40 CLM were detected. The number of metastases in each patient ranged from 1 to 12 (mean – 3). The size of metastases ranged from 9,1 mm to 150,0 mm (mean – 36,7 mm, median – 30,2 mm). 14 of all CLM (35%) were 20 mm and less. Right hemyhepatectomy was provided for 6 patients, left hemyhepatectomy – for one. In the second group 282 CLM were detected. The number of metastases in each patient ranged from 2 to 31 (mean – 11). The size of metastases ranged from 3,2 mm to 81,0 mm (mean – 17,4 mm, median – 12,7 mm). 209 of all CLM (74%) were equal or smaller then 20 mm in diameter.

Conclusion. FD-CT-A is the perspective method for detection and differentional diagnostics of CLM.
 

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