Impact of 18FDG Positron Emission Tomography - Computed Tomography (PET-CT) on Management of Gallbladder Carcinoma

Abstract

Background: Reports concerning the clinical usefulness 18F-FDG PET-CT for patients with gallbladder cancer are relatively scarce. The purpose of this study was to assess the diagnostic value of 18FGD- PET-CT in relation to a conventional imaging modality, multidetector row CT (MDCT), for patients with gallbladder cancer. Materials and Methods: Seventy patients with suspected gallbladder cancer who underwent both PET-CT and MDCT for initial staging were included in our study. The results of these two imaging modalities for evaluating primary tumors, regional lymph nodes and distant metastases were compared with the final diagnoses based on histopathological examination. Change in management of patients with gallbladder cancer based on PET-CT was also evaluated. Results: A maximum standardized uptake value (SUVmax) of 5.37 was taken as cutoff value for detecting a malignant tumor. PET-CT demonstrated no significant advantage over MDCT for the diagnosis of a primary tumor. PETCT showed a significantly higher accuracy (90.8 vs. 80.0%, P = 0.04) than that found for MDCT in the diagnosis of regional lymph node metastasis. PET-CT showed higher sensitivity (92.3 vs. 61.5%, P = 0.04) than that found for MDCT in the diagnosis of distant metastasis. Addition of PET-CT in preoperative staging of the disease changed management in 10 patients (14.3%). Conclusions: In patients with gallbladder carcinoma, the addition of 18FDG-PET-CT to standard staging CT may be helpful in detecting distant nodal metastasis and unsuspected metastatic disease that may preclude patients from surgical resection and result in a change of management in a significant number of patients.