Skip to main content

Advertisement

SpringerLink
Log in

Usefulness of 18F-FDG PET in intrahepatic cholangiocarcinoma

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Surgical resection is the only curative treatment strategy for intrahepatic cholangiocarcinoma (CC). Therefore, accurate staging is essential for appropriate management of patients with CC. We assessed the usefulness of 2-[18F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the staging of CC. We undertook a retrospective review of FDG PET images in 21 patients (10 female, 11 male; mean age 57 years) diagnosed with CC. Ten patients had hilar CC and 11, peripheral CC. Patients underwent abdominal magnetic resonance imaging (MRI) (n=20) and computed tomography (CT) (n=12) for the evaluation of primary tumours, and chest radiography and whole-body bone scintigraphy for work-up of distant metastases. For semi-quantitative analysis, the maximum voxel standardised uptake value (SUVmax) was obtained from the primary tumour. All peripheral CCs showed intensely increased FDG uptake, and some demonstrated ring-shaped uptake corresponding to peripheral rim enhancement on CT and/or MRI. In nine of the ten patients, hilar CCs demonstrated increased FDG uptake of a focal nodular or linear branching appearance. The remaining case was false negative on FDG PET. One patient with a false negative result on MRI demonstrated increased uptake on FDG PET. Among the ten hilar CCs, FDG uptake was intense in only two patients and was slightly higher than that of the hepatic parenchyma in the remaining patients. For the detection of lymph node metastasis, FDG PET and CT/MRI were concordant in 16 patients, and discordant in five (FDG PET was positive in three, and CT and MRI in two). FDG PET identified unsuspected distant metastases in four of the 21 patients; all of these patients had peripheral CC. FDG PET is useful in detecting the primary lesion in both hilar and peripheral CC and is of value in discovering unsuspected distant metastases in patients with peripheral CC. FDG PET could be useful in cases of suspected hilar CC with non-confirmatory biopsy and radiological findings.

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. 1a, b.
Fig. 2a, b.
Fig. 3a, b.
Fig. 4.
Fig. 5.
Fig. 6a, b.
Fig. 7a, b.

Similar content being viewed by others

References

  1. Ros PR, Buck JL, Goodman ZD, Ros AMV, Olmsted WW. Intrahepatic cholangiocarcinoma: radiologic-pathologic correlation. Radiology 1988; 176:689–693.

    Google Scholar 

  2. Edmonson HA, Craig JR. Peripheral cholangiocarcinoma. In: Schiff L, Schiff ER, eds. Disease of the liver. Philadelphia: J.B. Lippincott; 1984:1130–1136.

  3. Kawarada Y, Mizumoto R. Diagnosis and treatment of cholangiocellular carcinoma of the liver. Hepatogastroenterology 1990; 37:176–181.

    CAS  PubMed  Google Scholar 

  4. Schlinkert RT, Nagorney DM, van Heerden JA, Adson MA. Intrahepatic cholangiocarcinoma; clinical aspects, pathology and treatment. HPB Surg 1992; 5:95–101.

    CAS  PubMed  Google Scholar 

  5. Haug CE, Jenkins RL, Rohrer RJ, Auchincloss H, Delmonico FL, Freeman RB, Lewis WD, Cosimi AB. Liver transplantation for primary hepatic cancer. Transplantation 1992; 53:376.

    CAS  PubMed  Google Scholar 

  6. Hoh CK, Hawkins RA, Glaspy JA, Dahlbom M, Tse NY, Hoffman EJ, Schiepers C, Choi Y, Rege S, Nitzsche E. Cancer detection with whole-body PET using 2-[18F] fluoro-2-deoxy-d-glucose. J Comput Assist Tomogr 1993; 17:582–589.

    CAS  PubMed  Google Scholar 

  7. Keiding S, Hansen SB, Rasmussen HH, Gee A, Kruse A, Roelsgaard K, Tage-Jensen U, Dahlerup JF. Detection of cholangiocarcinoma in primary sclerosing cholangitis by positron emission tomography. Hepatology 1998; 28:700–706.

    CAS  PubMed  Google Scholar 

  8. Widjaja A, Mix H, Wagner S, Graz KF, van den Hoff J, Petrich T, Meier PN, Manns MP. Positron emission tomography and cholangiocarcinoma in primary sclerosing cholangitis. Z Gastroenterol 1999; 37:731–733.

    CAS  PubMed  Google Scholar 

  9. Okazumi S, Isono K, Enomoto K, Kikuchi T, Ozaki M, Yamamoto H, Hayashi H, Asano T, Ryu M. Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET: characterization of tumor and assessment of effect of treatment. J Nucl Med 1992; 33:333–339.

    CAS  PubMed  Google Scholar 

  10. Fritscher-Ravens A, Bohuslavizki KH, Broering DC, Jenicke L, Schafer H, Buchert R, Rogiers X, Clausen M. FDG PET in the diagnosis of hilar cholangiocarcinoma. Nucl Med Commun 2001; 22:1277–1285.

    Article  CAS  PubMed  Google Scholar 

  11. Kluge R, Schmidt F, Caca K, Barthel H, Hesse S, Georgi P, Seese A, Huster D, Berr F. Positron emission tomography with [18F]fluoro-2-deoxy-d-glucose for diagnosis and staging of bile duct cancer. Hepatology 2001; 33:1029–1035.

    CAS  PubMed  Google Scholar 

  12. Kato T, Tsukamoto E, Kuge Y, Katoh C, Nambu T, Nobuta A, Kondo S, Asaka M, Tamaki N. Clinical role of18F-FDG PET for initial staging of patients with extrahepatic bile duct cancer. Eur J Nucl Med Mol Imaging 2002; 29:1047–1054.

    Article  CAS  PubMed  Google Scholar 

  13. Okuda K, Kubo Y, Okazaki N, Arishima T, Hashimoto M. Clinical aspects of intrahepatic bile dut carcinoma including hilar carcinoma: a study of 57 autopsy proven cases. Cancer 1977; 39:232–246.

    CAS  PubMed  Google Scholar 

  14. Soyer P, Bluemke DA, Reichle R, Calhoun PS, Bliss DF, Scherrer A, Fishman EK. Imaging of intrahepatic cholangiocarcinoma. 1. Peripheral cholangiocarcinoma. AJR 1995; 165:1427–1431.

    CAS  Google Scholar 

  15. Nakeeb A, Pitt HA, Sohn TA, Coleman J, Abrams RA, Piantadosi S, Hruban RH, Lillemoe KD, Yeo CJ, Cameron JL. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 1996; 224:463–475.

    CAS  PubMed  Google Scholar 

  16. Worawattanakul S, Semelka R, Noone TC, Calvo BF, Kelekis NL, Woosley JT. Cholangiocarcinoma: spectrum of appearance on MR images using current techniques. Magn Reson Imaging 1998; 16:993–1003.

    Article  CAS  PubMed  Google Scholar 

  17. Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 1999; 19:61–77.

    CAS  PubMed  Google Scholar 

  18. Hamrick-Turner J, Abbitt PL, Ros PR. Intrahepatic cholangiocarcinoma: MR appearance. AJR 1992; 158:77–79.

    CAS  Google Scholar 

  19. Schoefl R, Haefner M, Wrba F, Pfeffel F, Stain C, Poetzi R, Gangl A. Forceps biopsy and brush cytology during endoscopic retrograde cholangiopancreatography for the diagnosis of biliary stenosis. Scand J Gastroenterol 1997; 32:363–368.

    CAS  PubMed  Google Scholar 

  20. Glasbrenner B, Ardan M, Boeck W, Preclik G, Moller P, Adler G. Prospective evaluation of brush cytology of biliary strictures during ERCP. Endoscopy 1999; 31:712–717.

    Article  CAS  PubMed  Google Scholar 

  21. Feydy A, Vilgrain V, Denys A, Sibert A, Belghiti J, Vullierme MP, Menu Y. Helical CT assessment in hilar cholangiocarcinoma: correlation with surgical and pathologic findings. AJR 1999; 172:73–77.

    CAS  Google Scholar 

  22. NakajimaT, Kondo Y, Miyazaki M, Okui K. A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma: histologic classification and modes of spreading. Hum Pathol 1988; 19:1228–1234.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea

    Young-Jin Kim

  2. Division of Nuclear Medicine, Department of Radiology, Yonsei University College of Medicine, 134 Shinchon-dong, 120-752, Seodaemoon-ku, Seoul, Korea

    Mijin Yun & Jong Doo Lee

  3. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

    Woo Jung Lee & Kyung Sik Kim

Authors
  1. Young-Jin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mijin Yun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Woo Jung Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kyung Sik Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jong Doo Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mijin Yun.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, YJ., Yun, M., Lee, W.J. et al. Usefulness of 18F-FDG PET in intrahepatic cholangiocarcinoma. Eur J Nucl Med Mol Imaging 30, 1467–1472 (2003). https://doi.org/10.1007/s00259-003-1297-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-003-1297-8

Keywords

Search

Navigation