Abstract
PURPOSE: Forty-one patients with biliary cancer (22 extrahepatic bile duct cancer, 11 gall bladder cancer, 8 ampullary cancer) who underwent 18F-fluorodeoxy-glucose positron emission tomography (FDG-PET) before treatment were enrolled in the present study. We investigated the clinical significance of PET for primary tumor, metastases and the other cancers. We also analyzed the relationship between the maximum standardized uptake value (SUVmax) and clinicopathologic factors. RESULTS: The accumulation of FDG to primary tumor was observed in 28 of 41 patients (68.3%). The sensitivity of FDG-PET was 100% for gallbladder cancer, 87.5% for ampullary cancer, and 45.4% for bile duct cancer, respectively. The SUVmax levels in primary tumor were significantly correlated with M-category in TNM classification (p=0.033). Meanwhile, 21 patients (51%) showed the FDG accumulation except for the primary tumor. The sensitivity for lymph node metastasis, liver metastasis, and peritoneal dissemination was 89%, 75%, and 100%, respectively. In the abnormal accumulations of the other regions in 8 patients, colon cancer was newly found in 3 patients. CONCLUSIONS: FDG-PET has a low sensitivity for detecting the primary tumor in biliary cancer, but it is useful for detection of distant metastasis and occult malignant disease.
