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J Hepatol. 2006 Jul;45(1):43-50. Epub 2006 Apr 19.

Impact of integrated positron emission tomography and computed tomography on staging and management of gallbladder cancer and cholangiocarcinoma.

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  • 1Swiss HPB (Hepato-Pancreato-Biliary) Center, Department of Visceral and Transplant Surgery, University Hospital Zurich, Switzerland.

Abstract

BACKGROUND/AIMS:

(1) To evaluate the diagnostic value of integrated positron emission and computed tomography (PET/CT) in comparison with contrast-enhanced CT (ceCT) to detect biliary tract tumors and associated distant and regional lymph node metastases and (2) to evaluate the impact of PET/CT on therapy management.

METHODS:

From January 2001 to March 2005, each patient who was treated for a malignancy of the biliary tract underwent PET/CT examination in addition to the standard work-up imaging. Data were prospectively collected and analyzed in comparison with ceCT.

RESULTS:

Sixty-one patients with malignancies of the biliary tract were included into the study. Diagnosis was proven in all patients either by histology or cytology. PET/CT detected all gallbladder cancers (n=14). PET/CT and ceCT provided a comparable accuracy for the primary intra- (n=14) and extra-hepatic cholangiocarcinomas (n=33). All distant metastases (12/12) were detected by PET/CT, but only 3/12 by ceCT (p<0.001). Regional lymph node metastases were detected by PET/CT and ceCT in only 12% vs. 24%. PET/CT findings resulted in a change of management in 17% of patients deemed resectable after standard work-up.

CONCLUSIONS:

PET/CT is particularly valuable in detecting unsuspected distant metastases which are not diagnosed by standard imaging. Thus, PET/CT staging has an important impact on selection of adequate therapy.

PMID:
16690156
DOI:
10.1016/j.jhep.2006.03.009
[PubMed - indexed for MEDLINE]
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