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Dynamic FDG-PET is useful for detection of cholangiocarcinoma in patients with PSC listed for liver transplantation

Prytz, Hanne LU ; Keiding, Susanne ; Bjornsson, Einar ; Broome, Ulrika ; Ahner, Sven ; Castedal, Maria and Munk, Ole Lajord (2006) In Hepatology 44(6). p.1572-1580
Abstract
Five to 15% of patients with primary sclerosing cholangitis (PSC) develop cholangiocarcinoma (CC) with a median survival of 5 to 7 months, an outcome not significantly improved by liver transplantation. However, if CC is found incidentally during the procedure or in the explanted liver, 5-year survival rates of 35% are reported. A noninvasive method to detect CC small enough to allow for intended curative surgery is needed. Unfortunately, computed tomography (CT) and ultrasonography (US) have poor sensitivity for detection of CC in PSC; however, positron emission tomography (PET) using 2-[F-18]fluoro-2-deoxy-D-glucose (FDG) differentiates well between CC and nonmalignant tissue. We examined whether PET findings are valid using a blinded... (More)
Five to 15% of patients with primary sclerosing cholangitis (PSC) develop cholangiocarcinoma (CC) with a median survival of 5 to 7 months, an outcome not significantly improved by liver transplantation. However, if CC is found incidentally during the procedure or in the explanted liver, 5-year survival rates of 35% are reported. A noninvasive method to detect CC small enough to allow for intended curative surgery is needed. Unfortunately, computed tomography (CT) and ultrasonography (US) have poor sensitivity for detection of CC in PSC; however, positron emission tomography (PET) using 2-[F-18]fluoro-2-deoxy-D-glucose (FDG) differentiates well between CC and nonmalignant tissue. We examined whether PET findings are valid using a blinded study design comparing pretransplantation FDG-PET results with histology of explanted livers. Dynamic FDG-PET was performed in 24 consecutive patients with PSC within 2 weeks after listing for liver transplantation and with no evidence of malignancy on CT, magnetic resonance imaging, or ultrasonography. The PET Center staff was blinded to clinical findings, and surgeons and pathologists were blinded to the PET results. Three patients had CC that was correctly identified by PET. PET was negative in I patient with high-grade hilar duct dysplasia. In 20 patients without malignancies, PET was false positive in I patient with epitheloid granulomas in the liver. In conclusion, dynamic FDG-PET appears superior to conventional imaging techniques for both detection and exclusion of CC in advanced PSC. FDG-PET may be useful for screening for CC in the pretransplant evaluation of patients with PSC. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Hepatology
volume
44
issue
6
pages
1572 - 1580
publisher
John Wiley and Sons
external identifiers
  • wos:000242540700027
  • scopus:33845600792
ISSN
1527-3350
DOI
10.1002/hep.21433
language
English
LU publication?
yes
id
5b2011cf-b88a-4510-96a4-b5886071ec79 (old id 685170)
date added to LUP
2016-04-01 15:51:20
date last changed
2021-01-06 04:20:16
@article{5b2011cf-b88a-4510-96a4-b5886071ec79,
  abstract     = {Five to 15% of patients with primary sclerosing cholangitis (PSC) develop cholangiocarcinoma (CC) with a median survival of 5 to 7 months, an outcome not significantly improved by liver transplantation. However, if CC is found incidentally during the procedure or in the explanted liver, 5-year survival rates of 35% are reported. A noninvasive method to detect CC small enough to allow for intended curative surgery is needed. Unfortunately, computed tomography (CT) and ultrasonography (US) have poor sensitivity for detection of CC in PSC; however, positron emission tomography (PET) using 2-[F-18]fluoro-2-deoxy-D-glucose (FDG) differentiates well between CC and nonmalignant tissue. We examined whether PET findings are valid using a blinded study design comparing pretransplantation FDG-PET results with histology of explanted livers. Dynamic FDG-PET was performed in 24 consecutive patients with PSC within 2 weeks after listing for liver transplantation and with no evidence of malignancy on CT, magnetic resonance imaging, or ultrasonography. The PET Center staff was blinded to clinical findings, and surgeons and pathologists were blinded to the PET results. Three patients had CC that was correctly identified by PET. PET was negative in I patient with high-grade hilar duct dysplasia. In 20 patients without malignancies, PET was false positive in I patient with epitheloid granulomas in the liver. In conclusion, dynamic FDG-PET appears superior to conventional imaging techniques for both detection and exclusion of CC in advanced PSC. FDG-PET may be useful for screening for CC in the pretransplant evaluation of patients with PSC.},
  author       = {Prytz, Hanne and Keiding, Susanne and Bjornsson, Einar and Broome, Ulrika and Ahner, Sven and Castedal, Maria and Munk, Ole Lajord},
  issn         = {1527-3350},
  language     = {eng},
  number       = {6},
  pages        = {1572--1580},
  publisher    = {John Wiley and Sons},
  series       = {Hepatology},
  title        = {Dynamic FDG-PET is useful for detection of cholangiocarcinoma in patients with PSC listed for liver transplantation},
  url          = {http://dx.doi.org/10.1002/hep.21433},
  doi          = {10.1002/hep.21433},
  volume       = {44},
  year         = {2006},
}