18F-fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer Journal Article
| Authors: | Corvera, C. U.; Blumgart, L. H.; Akhurst, T.; DeMatteo, R. P.; D'Angelica, M.; Fong, Y.; Jarnagin, W. R. |
| Article Title: | 18F-fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer |
| Abstract: | Background: Although 18F-fluorodeoxyglucose positron emission tomography (PET) has widespread clinical use, its role in cancers of the biliary tract is ill-defined. The aim of this study was to determine if preoperative PET provided additional staging information in patients with biliary tract cancer, beyond that obtained through conventional anatomic imaging. The role of PET in detecting disease recurrence after resection was also examined. Study Design: Between March 2001 and October 2003, 126 patients with biopsy-proved or presumed biliary tract cancer (intrahepatic or extrahepatic cholangiocarcinoma and gallbladder carcinoma) underwent PET in addition to standard imaging evaluation. Histologic confirmation of the diagnosis was used as the reference standard with which PET results were compared. Patient followup information and serial imaging were reviewed for progression of lesions detected by PET. Results: Of the 126 study patients, 93 (74%) underwent preoperative staging PET scans, the results of which changed the stage and treatment in 22 patients (24%): 15 of 62 (24%) with cholangiocarcinoma and 7 of 31 (23%) with gallbladder carcinoma. When used to assess for cancer recurrence (n = 33), PET identified disease in 86% of patients but altered treatment in only 9%. So, of the entire study group, the findings of PET influenced management in 20% of patients (24% preoperative staging and 9% cancer recurrence). The sensitivity of PET for identifying the primary tumor was 80% overall: 78% for cholangiocarcinoma, 86% for gallbladder carcinoma. Conclusions: Most biliary tract cancers are 18F-fluorodeoxyglucose avid tumors. In patients with potentially resectable tumors based on conventional imaging, PET identified occult metastatic disease and changed management in nearly one-fourth of all patients. PET also helped confirm recurrent cancer after resection. © 2008 American College of Surgeons. |
| Keywords: | adult; aged; aged, 80 and over; middle aged; major clinical study; disease course; histopathology; cancer recurrence; comparative study; cancer staging; positron emission tomography; recurrent cancer; follow up; methodology; neoplasm staging; radiopharmaceuticals; sensitivity analysis; neoplasm recurrence, local; diagnosis, differential; differential diagnosis; diagnostic imaging; diagnostic agent; disease progression; tumor recurrence; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; positron-emission tomography; radiopharmaceutical agent; scintiscanning; bile duct carcinoma; bile duct neoplasms; bile ducts, intrahepatic; cholangiocarcinoma; cholecystectomy; gallbladder neoplasms; biliary tract cancer; bile duct tumor; gallbladder tumor; intrahepatic bile duct |
| Journal Title: | Journal of the American College of Surgeons |
| Volume: | 206 |
| Issue: | 1 |
| ISSN: | 1072-7515 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2008-01-01 |
| Start Page: | 57 |
| End Page: | 65 |
| Language: | English |
| DOI: | 10.1016/j.jamcollsurg.2007.07.002 |
| PUBMED: | 18155569 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 44" - "Export Date: 17 November 2011" - "CODEN: JACSE" - "Source: Scopus" |
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