title: Use of (18)F-FDG PET/CT to locate primary malignancies in patients with hepatic cirrhosis and malignant ascites.
abstract: OBJECTIVE
  Ascites in patients with hepatic cirrhosis is caused by cirrhosis in most cases. For most malignant ascites, the primary malignancy could be readily identified using conventional imaging methods, e.g., computed tomography (CT) and magnetic resonance imaging (MRI). However, in a small fraction of the patients, the primary malignancy remains occult even with these examinations. In this retrospective study, we assessed the usefulness of (18)F-FDG PET/CT in patients with hepatic cirrhosis and malignant ascites of otherwise unknown origin.
  
  
  METHODS
  Twenty-eight patients with malignant ascites of unknown primary sites after CT, MRI and ultrasound during the period of five years between January 2008 and December 2012 had received (18)F-FDG PET/CT. Medical records of these patients were reviewed and analyzed.
  
  
  RESULTS
  Elevated (18)F-FDG absorption was found in 23 of 28 cases in the following sites: gastrointestinal tract (n=10, 43.5%), prostate (n=5, 21.7%), peritoneum (n=4, 13.3%), and ovary (n=4, 13.3%). Cancer was confirmed by pathology in 20 cases after open or laparoscopic surgeries. Five patients were found to have benign ascites, among which, 3 were found to be false positive due to tuberculosis. SUV values were significantly higher for tumors than for benign lesions (mean values, 6.95 vs. 2.94; P=0.005).
  
  
  CONCLUSIONS
  The (18)F-FDG PET/CT can be as a powerful imaging tool in identifying tissue origin in liver cirrhosis patients suspected of cancers or with cancers of unknown primary sites.
authors.affiliation: Department of Infectious Diseases, The People's Liberation Army 161 Hospital, Wuhan 430010, China;
authors.forename: He-Bin
authors.initials: HB
authors.lastname: Fan
authors.forename: Ai-Jun
authors.initials: AJ
authors.lastname: Wang
authors.forename: Dong-Liang
authors.initials: DL
authors.lastname: Yang
authors.forename: Jun
authors.initials: J
authors.lastname: Xiao
authors.forename: Yun
authors.initials: Y
authors.lastname: Ai
authors.forename: Lu
authors.initials: L
authors.lastname: Huang
authors.forename: Yong
authors.initials: Y
authors.lastname: Guo
authors.forename: Mu-Xiu
authors.initials: MX
authors.lastname: Zhou
authors.forename: Juan-Juan
authors.initials: JJ
authors.lastname: Wu
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
authors.forename: Fu-Ming
authors.initials: FM
authors.lastname: Yan
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Wang
keywords: PET/CT; cancer, ascites; liver cirrhosis