Gastrointestinal and Hepatopancreaticobiliary Services, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India.
J Hepatobiliary Pancreat Sci. 2020 Apr;27(4):164-170. doi: 10.1002/jhbp.712. Epub 2020 Feb 17.
This study aims to define the role of flurodeoxyglucose ( -FDG) positron emission tomography-contrast enhanced computed tomography (PETCECT) scan in upstaging disease in patients with locally advanced gallbladder cancer (LAGBC).
An analysis of a prospectively maintained database of gallbladder cancer (GBC) patients was performed. Patients found to have locally advanced (T3 and/or T4 or N+) but non-metastatic disease on initial imaging, either a contrast enhanced computed tomography (CECT) or a magnetic resonance imaging (MRI) scan, underwent an additional PETCECT for staging and the results impacting treatment decision were recorded.
One hundred and three patients of LAGBC underwent CECT/MRI and PETCECT. 48/103 (46.6%) were found to be upstaged to stage IV after PETCECT. The most common metastatic site was non-regional retroperitoneal lymph nodes (12 patients, 11.7%) followed by satellite lesions in liver (11, 10.7%). Fourteen (13.6%) patients had equivocal findings on PET scan that required confirmation by tissue sampling out of which 10 (71.4%) were subsequently found to have metastatic disease. The only statistically significant factor predicting distant spread on PETCECT was the presence of loco-regional nodes on CT scan (odds ratio 6.15, P = .006).
PETCECT is a valuable tool to rule out metastatic disease in patients presenting with LAGBC.
本研究旨在定义氟脱氧葡萄糖（-FDG）正电子发射断层扫描-对比增强计算机断层扫描（PET-CECT）在局部晚期胆囊癌（LAGBC）患者疾病分期中的作用。
对胆囊癌（GBC）患者的前瞻性数据库进行了分析。对初始影像学检查发现局部晚期（T3 和/或 T4 或 N+）但无远处转移的患者（无论是增强计算机断层扫描（CECT）还是磁共振成像（MRI）扫描）进行了额外的 PET-CECT 分期，记录影响治疗决策的结果。
103 例 LAGBC 患者接受了 CECT/MRI 和 PET-CECT 检查。48/103（46.6%）例患者在 PET-CECT 后被分期为 IV 期。最常见的转移部位是非区域性腹膜后淋巴结（12 例，11.7%），其次是肝脏卫星病变（11 例，10.7%）。14 例（13.6%）患者在 PET 扫描上存在可疑发现，需要通过组织取样来确认，其中 10 例（71.4%）随后发现存在转移性疾病。唯一具有统计学意义的预测 PET-CECT 远处转移的因素是 CT 扫描上存在局部区域淋巴结（比值比 6.15，P =.006）。
PET-CECT 是排除局部晚期胆囊癌患者远处转移的有价值工具。
