title: 18F-FDG PET/CT in differentiating malignant from benign origins of obstructive jaundice.
abstract: BACKGROUND
  The various origins of obstructive jaundice make the diagnosis of the disease difficult. This study was undertaken to evaluate the role of 18F-FDG PET/CT in differentiating malignant from benign origins of obstructive jaundice and to quantify the added value of 18F-FDG PET/CT over conventional imaging (enhanced CT and/or MRI).
  
  
  METHODS
  Eighty-five patients with obstructive jaundice who underwent 18F-FDG PET/CT within 2 weeks after enhanced CT and/or MRI were reviewed retrospectively. All 18F-FDG PET/CT images were independently evaluated by 2 nuclear medicine physicians who were unaware of other imaging data; differences were resolved by consensus of the physicians. All conventional imaging interpretations, according to the medical records, were reviewed by 2 radiologists to determine the potential value. Final diagnoses were based on histological or surgical findings.
  
  
  RESULTS
  Sixty-six patients were diagnosed with malignancies, and 19 patients with benign lesions. The maximum standardized uptake values for malignant and benign lesions causing biliary obstruction were 8.2+/-4.4 and 4.0+/-5.0, respectively (P<0.05). The sensitivity, specificity, and overall accuracy for differentiating malignant from benign origins with 18F-FDG PET/CT were 86.4% (57/66), 73.7% (14/19), and 83.5% (71/85), respectively. 18F-FDG PET/CT in conjunction with conventional imaging changed the sensitivity, specificity, and overall accuracy of conventional imaging alone from 75.8% (50/66) to 95.5% (63/66) (P<0.05), 68.4% (13/19) to 57.9% (11/19) (P>0.05), and 74.1% (63/85) to 87.1% (74/85) (P<0.05), respectively.
  
  
  CONCLUSIONS
  18F-FDG PET/CT is of great value in differentiating malignant from benign origins of obstructive jaundice and is a useful adjuvant to conventional imaging. 18F-FDG PET/CT should be recommended for further etiological clarification.
authors.affiliation: Nanfang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. wqslph@163.net.
authors.forename: Shao-Bo
authors.initials: SB
authors.lastname: Wang
authors.forename: Hu-Bing
authors.initials: HB
authors.lastname: Wu
authors.forename: Quan-Shi
authors.initials: QS
authors.lastname: Wang
authors.forename: Wen-Lan
authors.initials: WL
authors.lastname: Zhou
authors.forename: Ying
authors.initials: Y
authors.lastname: Tian
authors.forename: Yun-Hai
authors.initials: YH
authors.lastname: Ji
authors.forename: Liang
authors.initials: L
authors.lastname: Lv
mesh_terms: D000368:Aged; D001652:Bile Ducts / Q000473:pathology*; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis*; D002764:Cholecystitis / Q000150:complications / Q000175:diagnosis; D042883:Choledocholithiasis / Q000150:complications / Q000175:diagnosis; D003251:Constriction, Pathologic / Q000150:complications / Q000175:diagnosis; D004067:Digestive System Neoplasms / Q000150:complications / Q000175:diagnosis*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18