J Nucl Med. 2007; 48 (Supplement 2):389P
Oncology: Clinical Diagnosis-Solid Tumors
Clinical Diagnosis-Solid Tumors Posters |
The potential value of FDG-PET for the detection of gall bladder cancer or cholangiocarcinoma
Tevfik Cermik1,
Ayse Mavi2,
Gunsel Acikgoz1,
Simin Dadparvar1 and
Abass Alavi1
1 Radiology-Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; ;
2 Nuclear Medicine, Yeditepe University Hospital, Istanbul, Turkey
1650
Objectives: There are limited number of reports in literature describing role FDG PET in the detection of primary gall bladder cancer (GBCa) and cholangiocarcinoma (ChCa) at the time of initial presentation and during the follow-up of these patients. The aim of this study was to assess the contribution of this technique to the management of patients with these cancers. Methods: Thirty FDG-PET scans obtained from 23 patients (mean age: 61 ±13 Y; 15 F, 8 M) with primary GBCa or ChCa were retrospectively analyzed. Of the 30 studies, 8 were performed on the newly diagnosed GBCa or ChCa and were requested for initial staging before therapy while there was a suspicion of regional or distant metastases based on CT/MRI. The remaining 22 scans were performed during the follow-up period. Whole body FDG-PET images were obtained approximately 60 minutes after the intravenous administration of FDG (5.2 MBq/kg). The degree of FDG uptake of the lesion was assessed by calculating the maximum standardized uptake value (SUVmax). The results were compared with the clinical follow-up and surgical/histopathological results. Results: Of the 8 GBCa and ChCa lesions at the initial presentation, 6 were positive on both PET and CT/MRI. The average SUVmax of the primary lesions detected was 4.8±1.1. CT/MRI demonstrated nodal or distant metastases in 4 patients while PET showed such findings in 3 patients. The average SUVmax of the metastatic lesions was 5.2±1.7. On the 22 follow-up PET scans, the presence of lymph node metastases was detected in 11 patients and distant metastases in 6 patients. CT/MR images revealed evidence for lymph node metastases in 8 patients and distant metastases in 7. PET was true positive for detecting 2 metastatic lesions that could not be differentiated from postoperative changes on CT/MRI. However PET was false negative for one hepatic metastatic lesion. Conclusions: These data demonstrate that PET has similar results to those of the CT/MRI for detecting primary GBCa and ChCa. However, during the follow-up period, PET is more sensitive than CT/MRI for the detection of regional metastatic disease and complements the anatomical imaging modalities in the management of these patients.
