Skip to main content

Advertisement

SpringerLink
Log in

Diagnostic accuracy of F-18 FDG PET/CECT vs. CECT for detecting recurrence of periampullary carcinoma and its prognostic significance

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the additive value of whole-body F-18 fluoro-deoxyglucose positron emission tomography (FDG PET) as an adjunct to contrast-enhanced computed tomography (CECT) for detecting recurrence following Whipple’s resection for periampullary carcinoma and to analyze the prognostic significance of FDG PET-/CECT-based detection of recurrence.

Methods

Fifty patients (34 males, 16 females; mean age: 55 ± 11 years) who underwent PET/CECT following resection of periampullary carcinoma were included. The study was duly approved by the institutional ethical committee for retrospective analysis of the data. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of FDG PET/CECT and CECT alone for detection of recurrence were calculated, and the accuracy was compared with ROC analysis. The prognostic factors for survival following recurrence were analyzed by univariate and multivariate methods.

Results

PET/CECT indicated recurrence of disease in 26 (52%) patients. The overall mean survival time was 46 months with an overall survival rate of 42%. The sensitivity, specificity, PPV, NPV and accuracy of PET/CECT and CECT for detection of recurrence were 96.1%, 91.6%, 92.6%, 95.6%, 94% and 76.9%, 75%, 76.9%, 75%, 76%, respectively (p = 0.037). Also change in management could have been achieved in 18% of patients based on the PET/CECT results. In univariate analyses, SUVmax >7.3 was the only predictor of poor survival (p < 0.05).

Conclusion

PET/CECT could be used as a one-stop imaging tool for staging and prognostication of recurrent periampullary carcinoma that could result in better patient management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Sarmiento JM, Nagomey DM, Sarr MG, Farnell MB (2001) Periampullary cancers: are there differences? Surg Clin North Am 81:543–555

    Article  CAS  PubMed  Google Scholar 

  2. Berberat PO, Kunzli BM, Gulbinas A, et al. (2009) An audit of outcomes of a series of periampullary carcinomas. Eur J Surg Oncol 35:187–191

    Article  CAS  PubMed  Google Scholar 

  3. Yeo CJ, Cameron JL, Sohn TA, et al. (1997) Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg 226:248–257 (discussion 257–260)

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Yeo CJ, Sohn TA, Cameron JL, et al. (1998) Periampullary adenocarcinoma: analysis of 5-year survivors. Ann Surg 227:821–831

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Bouvet M, Gamagami RA, Gilpin EA, et al. (2000) Factors influencing survival after resection for periampullary neoplasms. Am J Surg 180:13–17

    Article  CAS  PubMed  Google Scholar 

  6. Schmidt CM, Powell ES, Yiannoutsos CT, et al. (2004) Pancreaticoduodenectomy: a 20-year experience in 516 patients. Arch Surg 139:718–725 (discussion 725–717)

    Article  PubMed  Google Scholar 

  7. Riall TS, Cameron JL, Lillemoe KD, et al. (2005) Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma–part 3: update on 5-year survival. J Gastrointest Surg 9:1191–1204 (discussion 1204-1196)

    Article  PubMed  Google Scholar 

  8. Kim JK, Ha HK, Han DJ, Auh YH (2003) CT analysis of postoperative tumor recurrence patterns in periampullary cancer. Abdom Imaging 28:384–391

    Article  CAS  PubMed  Google Scholar 

  9. Carter JT, Grenert JP, Rubenstein L, et al. (2008) Tumors of the ampulla of vater: histopathologic classification and predictors of survival. J Am Coll Surg 207:210–218

    Article  PubMed  Google Scholar 

  10. Kim WS, Choi DW, Choi SH, et al. (2012) Clinical significance of pathologic subtype in curatively resected ampulla of vater cancer. J Surg Oncol 105:266–272

    Article  PubMed  Google Scholar 

  11. Riall TS, Cameron JL, Lillemoe KD, et al. (2006) Resected periampullary adenocarcinoma: 5-year survivors and their 6- to 10-year follow-up. Surgery 140:764–772

    Article  PubMed  Google Scholar 

  12. Sperti C, Pasquali C, Fiore V, et al. (2006) Clinical usefulness of 18-fluorodeoxyglucose positron emission tomography in the management of patients with nonpancreatic periampullary neoplasms. Am J Surg 191:743–748

    Article  PubMed  Google Scholar 

  13. Ruf J, Lopez Hanninen E, Oettle H, et al. (2005) Detection of recurrent pancreatic cancer: comparison of FDG-PET with CT/MRI. Pancreatology 5:266–272

    Article  PubMed  Google Scholar 

  14. Sperti C, Pasquali C, Bissoli S, et al. (2010) Tumor relapse after pancreatic cancer resection is detected earlier by 18-FDG PET than by CT. J Gastrointest Surg 14:131–140

    Article  PubMed  Google Scholar 

  15. Mortele KJ, Lemmerling M, de Hemptinne B, et al. (2000) Postoperative findings following the Whipple procedure: determination of prevalence and morphologic abdominal CT features. Eur Radiol 10:123–128

    Article  CAS  PubMed  Google Scholar 

  16. Sperti C, Pasquali C, Catalini S, et al. (1993) CA 19-9 as a prognostic index after resection for pancreatic cancer. J Surg Oncol 52:137–141

    Article  CAS  PubMed  Google Scholar 

  17. Coombs RJ, Zeiss J, Howard JM, et al. (1990) CT of the abdomen after the Whipple procedure: value in depicting postoperative anatomy, surgical complications, and tumor recurrence. AJR Am J Roentgenol 154:1011–1014

    Article  CAS  PubMed  Google Scholar 

  18. Lepanto L, Gianfelice D, Dery R, et al. (1994) Postoperative changes, complications, and recurrent disease after Whipple’s operation: CT features. AJR Am J Roentgenol 163:841–846

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Nuclear medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Sampath Santhosh, Bhagwant Rai Mittal & Anish Bhattacharya

  2. Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Mandeep Kang

  3. Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Rakesh Kapoor

  4. Department of Surgical Gasteroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Rajesh Gupta

  5. Department of Medical Gasteroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Surinder Rana & Deepak Bhasin

  6. Institute of Nuclear Imaging and Molecular Medicine, Tamil Nadu Govt. Multi Super Specialty Hospital, Omandurar Government Estate, Anna Salai, Chennai, 600002, Tamil Nadu, India

    Sampath Santhosh

Authors
  1. Sampath Santhosh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bhagwant Rai Mittal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mandeep Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rakesh Kapoor
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rajesh Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Surinder Rana
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anish Bhattacharya
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Deepak Bhasin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sampath Santhosh.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Santhosh, S., Mittal, B.R., Kang, M. et al. Diagnostic accuracy of F-18 FDG PET/CECT vs. CECT for detecting recurrence of periampullary carcinoma and its prognostic significance. Abdom Imaging 40, 1131–1137 (2015). https://doi.org/10.1007/s00261-015-0371-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-015-0371-6

Keywords

Search

Navigation