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The Role of F-18 FDG PET/CT in Intrahepatic Cholangiocarcinoma

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Abstract

Purpose

The aim of this study was to evaluate the diagnostic and prognostic role of metabolic parameters of FDG PET/CT in patients with intrahepatic cholangiocarcinoma (ICC).

Methods

From December 2008 to December 2013, 76 FDG PET/CT scans performed for initial staging of ICC in a single institution (57 male and 19 female; mean age 68 ± 9 years) were retrospectively reviewed. Patients with history of other known malignancy were excluded. Detection rates of regional lymph node and distant metastasis by FDG PET/CT were analyzed in comparison with conventional imaging modalities such as CT or MRI. Metabolic parameters including maximum, peak and mean standardized uptake values (SUVmax, SUVpeak, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), glucose corrected SUV (SUVgluc), and glucose corrected TLG (TLGgluc) were measured for the primary tumor. Cut-off values for the metabolic parameters were calculated by ROC curve analysis, and used to dichotomize the patient groups. The overall survival time (OS) was calculated and compared using the Cox proportional hazard regression analysis.

Results

The median duration of follow-up period was 5.4 months (interquartile range: 1.45∼15.45). FDG PET/CT showed higher sensitivity than conventional imaging modalities in detection of regional node involvement (74.5 % vs. 61.8 %, p = 0.013). In six patients, distant metastasis was identified only by FDG PET/CT. The mean SUVmax, SUVpeak, SUVmean, MTV, and TLG for the primary tumor were 8.2 ± 3.1, 6.8 ± 2.5, 4.0 ± 0.8, 192.7 ± 360.5 cm3, and 823.7 ± 1615.4, respectively. Patients with higher (≥7.3, HR: 4.280, p = 0.001), higher SUVpeak (≥6.5, HR: 2.333, p = 0.020), higher SUVmean (≥3.9, HR: 2.799, p = 0.004), higher SUVgluc (≥8.1, HR: 2.648, p = 0.012), and higher TLGgluc (≥431.6, HR: 2.186, p = 0.030) showed significantly shorter survival time. By multivariate study, operability was an independent prognostic factor for longer survival (HR: 4.113, p = 0.005).

Conclusion

FDG PET/CT is an important diagnostic imaging tool in the nodal staging and detection of distant metastasis in ICC patients. Metabolic parameters may have a significant role as prognostic factors in patients with ICC.

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Authors and Affiliations

  1. Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seochogu, Seoul, 137-701, Korea

    Yeongjoo Lee, Ie Ryung Yoo, Sun Ha Boo, Hyoungwoo Kim, Hye Lim Park & Joo Hyun O

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  1. Yeongjoo Lee
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  2. Ie Ryung Yoo
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Correspondence to Ie Ryung Yoo.

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This study was not funded.

Conflict of Interest

Yeongjoo Lee, Ie Ryung Yoo, Sun Ha Boo, Hyoungwoo Kim, Hye Lim Park, and Joo Hyun O declare that they have no conflict of interest.

Ethical Statement

The study was approved by an institutional review board or equivalent and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The institutional review board waived the need to obtain informed consent.

Ethical Approvement

This article does not contain any studies with human participants or animals performed by any of the authors.

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Lee, Y., Yoo, I.R., Boo, S.H. et al. The Role of F-18 FDG PET/CT in Intrahepatic Cholangiocarcinoma. Nucl Med Mol Imaging 51, 69–78 (2017). https://doi.org/10.1007/s13139-016-0440-y

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  • DOI: https://doi.org/10.1007/s13139-016-0440-y

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