Preoperative assessment of hilar cholangiocarcinoma by dual-modality PET/CT

BACKGROUND: The purpose of the current study was to evaluate the accuracy of (18)F-FDG PET/CT in staging hilar cholangiocarcinoma.

MATERIALS AND METHODS: From June 2004 to December 2007, patients evaluated for surgical treatment of hilar cholangiocarcinoma were entered into a prospective database. Dual modality (18)F-FDG PET/CT was performed before surgery. The report was reviewed with comparison to the operative and pathological results in each case for tumour-node-metastasis staging.

RESULTS: Seventeen patients (6 women, 11 men) of a median age of 62 years were included in the study. Radical tumour resection was performed on seven patients. Ten patients underwent surgical exploration. The sensitivity of PET/CT in detecting primary tumour was found to be 58.8% (25% in T2 tumour, 70% in T3 tumour, 66.7% in T4 tumour). The sensitivity/specificity of PET/CT in detecting lymph node metastasis and distant metastasis were 41.7%/80% and 55.6%/87.5%, respectively. Positive (18)F-FDG uptake in the bile duct was found to be associated with surgical non-resectability (P = 0.05).

CONCLUSION: Dual-modality PET/CT imaging was found to have a high specificity in detection of lymph node and distant metastasis in hilar cholangiocarcinoma, with a limited value in correct judgement of surgical resectability for tumours in stadium UICC I-III.