Usefulness of 18F-fluorodeoxyglucose positron emission tomography in differential diagnosis and staging of cholangiocarcinomas |
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Authors: | Moon Chang Mo Bang Seungmin Chung Jae Bock Park Seung Woo Song Si Young Yun Mijin Lee Jong Doo |
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Institution: | Division of Gastroenterology, Institute of Gastroenterology, Departments of Internal Medicine and;Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea |
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Abstract: | Background and Aim: 18F‐Fluoro‐2‐deoxy‐d ‐glucose positron emission tomography (18FDG‐PET) is promising for diagnosis and treatment of various malignancies. The aim of this study was to evaluate the clinical usefulness of 18FDG‐PET in differential diagnosis and staging of cholangiocarcinomas according to the intrahepatic, perihilar and common bile duct lesions and to compare with computerized tomography (CT) scan. Methods: From January 2000 to September 2003, 54 patients with suspected cholangiocarcinoma underwent abdominal CT scan and 18FDG‐PET within a 2‐week period. The PET images were analyzed visually and semiquantitatively. Results: The overall accuracy of 18FDG‐PET for discriminating malignant diseases of bile duct from benign conditions was slightly higher than that of CT scan (88.9% vs 81.5%). The sensitivity of 18FDG‐PET in perihilar cholangiocarcinoma was lower than the value of intrahepatic and common bile duct cancers (83.3% vs 91.3%, 90.9%); moreover, in cases of perihilar cancer, the sensitivity of 18FDG‐PET was lower than that of CT scans (83.3% vs 91.7%). 18FDG‐PET detected nine distant metastatic lesions not found by other imaging studies and excluded two patients who potentially had resectable condition in other imaging studies from unnecessary laparotomy. Conclusion: The clinical usefulness of 18FDG‐PET in differential diagnosis of bile duct cancers is related to the site of primary disease. Although it is a helpful method for differential diagnosis especially in cases of intrahepatic and common bile duct cancers, 18FDG‐PET can not provide confirmative clues in perihilar cholangiocarcinoma. 18FDG‐PET may hold promise in the detection of hidden distant metastasis and can play an additional role in the evaluation of resectability. 18FDG‐PET can be complementary to CT scan in diagnosing and staging of cholangiocarcinoma. |
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Keywords: | cholangiocarcinoma computed tomography positron emission tomography |
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