Preoperative Assessment of Hilar Cholangiocarcinoma by Dual-Modality PET/CT

Background: The purpose of the current study was to evaluate the accuracy of F-18-FDG PET/CT in staging hilar cholangiocarcinoma. Materials and Methods: Front June 2004 to December 2007, patients evaluated for surgical treatment of hilar cholangiocarcinoma were entered into a prospective database. Dual modality F-18-FDG PET/CT was performed before surgery. The report was reviewed with comparison to the operative and pathological results in each case for tumour-node-metastasis staging. Results: Seventeen patients (6 women, 11 men) of a median age of 62 years were included in the study. Radical tumour resection was performed on seven patients. Ten patients underwent surgical exploration. The sensitivity of PET/CT in detecting primary tumour was found to be 58.8% (25% in T2 tumour, 70% in T3 tumour, 66.7% in T4 tumour). The sensitivity/specificity of PET/CT in detecting lymph node metastasis and distant metastasis were 41.7%/80% and 55.6%/87.5%, respectively. Positive 18F-FDG uptake in the bile duct was found to be associated with surgical non-resectability (P=0.05). Conclusion: Dual-modality PET/CT imaging was found to have a high specificity in detection of lymph node and distant metastasis in hilar cholangiocarcinoma, with a limited value in correct judgement of surgical resectability for tumours in stadium UICC I-III. J. Surg. Oncol. 2008:98:438-443. (c) 2008 Wiley-Liss, Inc.