Role of 18F-FDG PET/CT Imaging in Intrahepatic Cholangiocarcinoma.

Abstract

PURPOSE:

Although intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy after hepatocellular carcinoma, there are limited data available on PET/CT imaging in ICC. This retrospective study analyzed the role of PET/CT imaging in the evaluation of ICC.

METHODS:

FDG PET/CT findings were reviewed in 65 patients with histologically confirmed ICC. PET/CT was evaluated based on visual interpretation and the semiquantitative index of SUVmax and tumor-to-normal liver tissue ratio (TNR), which were consequently further analyzed and correlated with tumor localization, differentiation, size, and serum levels of tumor markers. Forty-five cases also underwent abdominal MRI examinations.

RESULTS:

Nineteen patients had hilar ICC, whereas 46 patients had peripheral ICC. Sixty cases of ICC showed elevated FDG uptake with an average SUVmax of 8.3 ± 4.7 and TNR of 3.1 ± 1.7. Five cases located in the hilum were false negative on PET/CT imaging. Compared with hilar ICC, SUVmax and TNR of peripheral ICC were significantly higher (P < 0.05). FDG accumulation correlated with the degree of ICC differentiation. SUVmax and TNR correlated with tumor size, whereas there was no correlation observed with serum levels of carbohydrate antigen 19-9. The sensitivity, specificity, and accuracy of PET/CT and MRI in the diagnosis of regional lymph node metastases were 70.0% versus 50%, 91.7% versus 83.3%, and 81.8% versus 68.2%, respectively. PET/CT upstaged 12.3% and downstaged 3.1% of cases and had no impact on patient management in the remaining 84.6% of cases.

CONCLUSIONS:

Combination of FDG PET/CT and abdominal MRI might improve the diagnostic accuracy for ICC.

• Authors: Lei Jiang, Hui Tan, Cedric M Panje, Haojun Yu, Yan Xiu, Hongcheng Shi
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 41 Issue 1 Pg. 1-7 (Jan 2016) ISSN: 1536-0229 [Electronic] United States
• PMID: 26402131 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Aged, 80 and over
• Bile Duct Neoplasms (blood, diagnostic imaging, pathology)
• Bile Ducts, Intrahepatic
• Biomarkers, Tumor (blood)
• Carcinoma, Hepatocellular (diagnostic imaging)
• Cholangiocarcinoma (blood, diagnostic imaging, pathology)
• Female
• Fluorodeoxyglucose F18
• Humans
• Klatskin Tumor
• Liver Neoplasms (diagnostic imaging)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Multimodal Imaging
• Positron-Emission Tomography (methods)
• Retrospective Studies
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods)