Department of Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
HPB (Oxford). 2008;10(6):439-45. doi: 10.1080/13651820802286910.
Radical re-resection is offered to patients with non-metastatic, invasive, incidental gallbladder cancer. Data evaluating (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in patients with incidental gallbladder cancer is sparse.
To evaluate the efficacy of integrated (18)F-FDG PET-CT in determining occult metastatic or residual local-regional disease in patients with incidental gallbladder cancer.
Patients referred with incidental gallbladder cancer for radical re-resection were evaluated using multidetector computed tomography (MDCT) and PET-CT. Based on preoperative imaging, 24 out of 92 patients were found suitable for surgery. The two imaging modalities were evaluated with respect to residual and resectable disease.
In determining residual disease, MDCT had a sensitivity and positive predictive value (PPV) of 42.8%, each, while PET-CT had a sensitivity and PPV of 28.5 and 20%, respectively. In determining resectability, MDCT had a sensitivity, PPV, and accuracy of 100, 87.5, and 87.5%, respectively, as compared to PET-CT (sensitivity=100%, PPV=91.3%, accuracy=91.6%).
From our study, it appears that in patients with incidental gall bladder cancer without metastatic disease, PET-CT and MDCT seem to have roles complementing each other. PET-CT was able to detect occult metastatic or residual local-regional disease in some of these patients, and seems to be useful in the preoperative diagnostic algorithm of patients whose MDCT is normal or indicates locally advanced disease.
对于非转移性、浸润性、偶发胆囊癌患者，可提供激进性再次切除术。关于偶发性胆囊癌患者的（18）氟-氟代脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（（18）F-FDG PET-CT）数据评估较为稀少。
评估整合（18）F-FDG PET-CT 在确定偶发性胆囊癌患者隐匿性转移性或局部区域性残留疾病中的疗效。
对因偶发性胆囊癌行激进性再次切除术的患者进行多排螺旋计算机断层扫描（MDCT）和 PET-CT 评估。根据术前影像学检查，92 例患者中有 24 例适合手术。评估两种影像学方法在残留和可切除疾病方面的表现。
在确定残留疾病方面，MDCT 的敏感性和阳性预测值（PPV）分别为 42.8%，而 PET-CT 的敏感性和 PPV 分别为 28.5%和 20%。在确定可切除性方面，MDCT 的敏感性、PPV 和准确性分别为 100%、87.5%和 87.5%，而 PET-CT 分别为 100%、91.3%和 91.6%。
根据我们的研究，似乎在无转移疾病的偶发性胆囊癌患者中，PET-CT 和 MDCT 似乎具有互补作用。PET-CT 能够在部分患者中检测到隐匿性转移性或局部区域性残留疾病，似乎对 MDCT 正常或提示局部晚期疾病的患者的术前诊断算法有用。
