Gu Xin-jin, Wang Bao-fu, Liu Rong
Department of Oncological Surgery, PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2012 May 29;92(20):1409-12.
To evaluate the value of positron emission tomography/computed tomography (PET/CT) in the preoperative assessment of hilar cholangiocarcinoma (HC).
A retrospective analysis was performed for 32 HC patients. There were 14 females and 18 males with a mean age of 56 years old. All cases were confirmed by surgery, pathology or other diagnostic modalities. ¹⁸F-fluorodeoxyglucose (FDG) PET/CT was performed preoperatively in all patients. The images were interpreted and compared with the operative and pathological outcomes in each case.
Among them, according to the Bismuth-Corlette classification, the number of types I, II, IIIa, IIIb and IV patients, were 3, 2, 4, 8 and 15 respectively. Radical tumor resection was performed in 16 patients. Among them, 3, 2, 1, 7 and 3 patient belonged to types I, II, IIIa, IIIb and IV respectively. Seven patients underwent palliative surgery and 9 had only surgical exploration. The detecting accuracy of PET/CT in primary tumors Bismuth-Corlette classification reached 81.25% (26/32). The sensitivity, specificity and accuracy of PET/CT in detecting lymph node metastasis and distant metastasis were 64.7%, 86.7%, 75.0% and 41.7%, 95.0%, 75.0% respectively. The concordance rate of preoperative evaluation of respectability by PET/CT and intraoperative evaluation was 75.0%. No significant difference existed between PET/CT and the surgical and histopathologic findings in the evaluation of curative resectability for HC (χ² = 0.125, P > 0.05).
¹⁸F-FDG PET/CT is of great value in the diagnosis of HC, as well as in detecting lymph node metastasis and distant metastasis. Thus ¹⁸F-FDG PET/CT is helpful in the preoperative assessment of resectability for HC.
评估正电子发射断层扫描/计算机断层扫描(PET/CT)在肝门部胆管癌(HC)术前评估中的价值。
对32例HC患者进行回顾性分析。其中女性14例,男性18例,平均年龄56岁。所有病例均经手术、病理或其他诊断方法确诊。所有患者术前均行¹⁸F-氟脱氧葡萄糖(FDG)PET/CT检查。对图像进行解读,并与各病例的手术及病理结果进行比较。
其中,根据Bismuth-Corlette分类,Ⅰ型、Ⅱ型、Ⅲa型、Ⅲb型和Ⅳ型患者的数量分别为3例、2例、4例、8例和15例。16例患者行根治性肿瘤切除术。其中,分别属于Ⅰ型、Ⅱ型、Ⅲa型、Ⅲb型和Ⅳ型的患者为3例、2例、1例、7例和3例。7例患者接受了姑息性手术,9例仅进行了手术探查。PET/CT对原发性肿瘤Bismuth-Corlette分类的检测准确率达到81.25%(26/32)。PET/CT检测淋巴结转移和远处转移的敏感性、特异性和准确性分别为64.7%、86.7%、75.0%和41.7%、95.0%、75.0%。PET/CT术前可切除性评估与术中评估的一致性率为75.0%。在HC根治性可切除性评估中,PET/CT与手术及组织病理学结果之间无显著差异(χ² = 0.125,P > 0.05)。
¹⁸F-FDG PET/CT在HC的诊断以及检测淋巴结转移和远处转移方面具有重要价值。因此,¹⁸F-FDG PET/CT有助于HC术前可切除性的评估。