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Role of dual-time point 18F-FDG PET/CT imaging in the primary diagnosis and staging of hilar cholangiocarcinoma.

Authors
  • Pang, Lifang1, 2, 3
  • Bo, Xiaobo4, 5
  • Wang, Jie4, 5
  • Wang, Changcheng4, 5
  • Wang, Yueqi4, 5
  • Liu, Guobing1, 2, 3
  • Yu, Haojun1, 2, 3
  • Chen, Lingli6
  • Shi, Hongcheng7, 8, 9
  • Liu, Houbao10, 11, 12
  • 1 Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Shanghai, 200032, People's Republic of China. , (China)
  • 2 Shanghai Institute of Medical Imaging, Shanghai, 200032, China. , (China)
  • 3 Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China. , (China)
  • 4 Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. , (China)
  • 5 Biliary Tract Diseases Institute, Fudan University, No. 180, Fenglin Road, Shanghai, 200032, China. , (China)
  • 6 Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. , (China)
  • 7 Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Shanghai, 200032, People's Republic of China. [email protected] , (China)
  • 8 Shanghai Institute of Medical Imaging, Shanghai, 200032, China. [email protected] , (China)
  • 9 Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China. [email protected] , (China)
  • 10 Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. [email protected] , (China)
  • 11 Biliary Tract Diseases Institute, Fudan University, No. 180, Fenglin Road, Shanghai, 200032, China. [email protected] , (China)
  • 12 General Surgery Department, Zhongshan-Xuhui Hospital Affiliated to Fudan University, No. 966, Middle Huaihai Rd, Shanghai, 200031, China. [email protected] , (China)
Type
Published Article
Journal
Abdominal radiology (New York)
Publication Date
Sep 01, 2021
Volume
46
Issue
9
Pages
4138–4147
Identifiers
DOI: 10.1007/s00261-021-03071-2
PMID: 33825930
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim of this study was to evaluate the role of dual-time point 18F-FDG PET/CT imaging in the primary diagnosis and staging of hilar cholangiocarcinoma (HCCA). Dual-time point FDG PET/CT findings, including early phase whole-body scanning and abdominal delayed phased performed 1 and 2 h after radiotracer injection, respectively, were retrospective reviewed in 69 patients conformed HCCA by histology. PET/CT was evaluated based on visual interpretation and the semiquantitative index of SUVmax and tumor-to-normal liver tissue ratio (TNR) for both early and delayed images. For all 69 HCCA patients, the mean SUVmax of the lesion and TNR in delayed phase was significantly higher than that in early phase (6.1 ± 4.7, 2.2 ± 1.7, vs 5.1 ± 3.4, 1.6 ± 1.1; P < 0.001). The sensitivity and accuracy value of detection primary lesions was 69.6% and 70% in early phase vs 76.8% and 76.8% in delay phase, respectively. There was a significant correlation between lesion SUVmax and Ki67 index in both dual-time imaging (r = 0.462, P < 0.001 in early phase vs r = 0.47, P < 0.001 in delay phase). The sensitivity, specificity and accuracy value of metastatic lymph nodes prediction was 50%, 67.3% and 71% in early phase vs 62.5%, 73.3% and 76.8% in delayed phase, respectively. The sensitivity, specificity and accuracy of FDG PET/CT in detecting distant metastasis in our study was 75%, 100% and 97.1%. There was no difference of predicting distant metastasis between early phase and delayed phase. Delayed phase in dual-time point 18F-FDG PET/CT scan provides additional usefulness for detection primary tumor and lymph nodes metastases in HCCA, but there was no added benefit of delayed PET/CT imaging in detection of distant metastases in this study. SUVmax in early and delayed phase could be used to assess tumor aggressiveness in pre-treatment HCCA. © 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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