Usefulness of Preoperative 18F-FDG-PET in Detecting Invasive Intraductal Papillary Neoplasm of the Bile Duct

Anticancer Res. 2018 Jun;38(6):3677-3682. doi: 10.21873/anticanres.12645.

Abstract

Background/aim: Preoperative identification of the invasive component remains challenging in intraductal papillary neoplasm of the bile duct (IPNB). We evaluated the ability of preoperative 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) to differentiate between non-invasive IPNB, invasive IPNB, and papillary cholangiocarcinoma (CCA).

Patients and methods: The maximum standardized uptake values (SUVmax) of 11 patients with IPNB (6 non-invasive and 5 invasive) and 20 with papillary CCA who underwent pre-surgical 18F-FDG-PET were assessed. The SUVmax cut-off that predicts an invasive component was determined using receiver operating characteristic (ROC) curve analysis.

Results: The SUVmax in patients with invasive IPNB and papillary CCA were significantly higher than in patients with non-invasive IPNB (p=0.035 and 0.0025, respectively). ROC curve analysis revealed an optimal SUVmax cut-off of 4.5, which had 94.5% accuracy, 76.0% sensitivity, and 100% specificity.

Conclusion: Our data suggest that the preoperative 18F-FDG-PET SUVmax can differentiate non-invasive IPNB from invasive IPNB and papillary CCA.

Keywords: 18F-FDG-PET; Intraductal papillary neoplasm of the bile duct; SUVmax; papillary cholangiocarcinoma.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / diagnostic imaging*
  • Bile Duct Neoplasms / pathology
  • Bile Ducts, Intrahepatic / diagnostic imaging*
  • Bile Ducts, Intrahepatic / pathology
  • Carcinoma, Papillary / diagnostic imaging*
  • Carcinoma, Papillary / pathology
  • Cholangiocarcinoma / diagnostic imaging
  • Cholangiocarcinoma / pathology
  • Diagnosis, Differential
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Positron-Emission Tomography / methods*
  • Preoperative Period
  • ROC Curve

Substances

  • Fluorodeoxyglucose F18