Detection of invisible metastatic lesion of digestive cancer using positron emission tomography and therapeutic strategy against hepatic metastasis

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Even if hepatic metastasis is too small to be detected existing diagnostic modalities, the ratio between arterial and portal blood flow in the liver should change, that is, arterial hepatic blood flow increase and portal hepatic blood flow decrease in the liver.. To know this phenomenon with positron emission tomography make the early detection of hepatic metastasis possible, and early treatment for liver metastasis can be started. However, if extra hepatc metastasis exist, treatment for the only liver is non sense.On the other hand, it is clarified that small extra hepatic metastatic lesion can be detected with 18-fluorodeoxy glucose positron emission tomography. Therefore, simultaneous quantification of hepatic arterial and portal blood flow using 15-water and, systemic measurement of glucose metabolism using 18-fluorodeoxy glucose with positron emission tomography prove existence of invisible liver metastasis and absence of extra hepatic metastatic lesion. This method will improve the treatment performance for metastatic liver cancer.