Clinical impact of whole body FDG-PET for recurrent biliary cancer: a multicenter study.
OBJECTIVE
To evaluate the clinical usefulness of positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) in patients with follow-up or suspected recurrent biliary cancer in a multicenter study.


METHODS
We performed a retrospective review of 50 patients who underwent FDG-PET (either integrated PET/CT or manual fusion of dedicated PET and CT) scans for post-treatment surveillance of biliary cancer. Recurrence was suspected in 40 of these patients on the basis of tumor marker levels, and/or findings of conventional imaging (group A). Clinical findings in the remaining 10 patients showed them to be disease-free (group B). The diagnostic performance and clinical impact of PET were analyzed.


RESULTS
Recurrence was confirmed in 28 out of the 40 patients in group A, and 1 of the 10 patients in group B. Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET for detecting recurrence were 86% (25/29), 91% (19/21), and 88% (44/50), respectively. The one patient with recurrence in group B was correctly interpreted by PET. Positive test likelihood ratio and negative test likelihood ratio were increased from 1.69 to 9.05, and 0.08 to 0.32, respectively, after PET study. The findings of PET resulted in a change of management for 10 out of the 50 patients (20%) by initiating an unplanned treatment strategy (n = 7), by obviating the need for planned diagnostic procedures (n = 2), or by changing the treatment plan (n = 1).


CONCLUSIONS
FDG-PET/CT or PET with CT yielded helpful information in patients with suspected recurrent biliary cancer.
Kitajima
Kazuhiro
K
Department of Radiology, Dokkyo Medical University School of Medicine, Shimotuka-gun, Tochigi, 321-0293, Japan. kazu10041976@yahoo.co.jp
Murakami
Koji
K
Kanegae
Kakuko
K
Tamaki
Nagara
N
Kaneta
Tomohiro
T
Fukuda
Hiroshi
H
Nakajima
Kotaro
K
Fujii
Hirofumi
H
Tateishi
Ukihide
U
Kubota
Kazuo
K
Suga
Tsuyoshi
T
Nakamoto
Yuji
Y
D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
D019788:Fluorodeoxyglucose F18