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Diagnostic performance of F-18 FDG PET/CT in recurrent adenocarcinoma gallbladder and its impact on post-recurrence survival

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To analyze diagnostic performance of F-18 FDG PET/CT in recurrent adenocarcinoma gallbladder (GBC) and to establish its possible impact on post-recurrence survival.

Method

FDG PET/CT studies of suspected recurrent GBC were retrospectively analyzed alongside tumor markers serum CEA and CA 19-9. Abnormal FDG-avid lesions and abnormal morphological lesions were considered positive for recurrence, and were categorized as isolated abdominal wall recurrence, loco-regional recurrence, and distant metastatic disease. Histopathology, definite progression on imaging and positive response to treatment was considered as reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were used as diagnostic performance parameters. Post-recurrence survival was calculated whenever appropriate follow-up was available, based on the abovementioned categories of sites of recurrence using survival curves and log-rank test.

Results

Out of 117 PET/CT studies, 93 (79.5%) were positive and 24 (20.5%) were negative for recurrence. 86 out of 93 were true positive and 23 of 24 were true negative. PET/CT demonstrated sensitivity, specificity, PPV, NPV and accuracy of 98.8%, 76.7%, 92.5%, 95.8% and 93.1%, respectively. Diagnostic performance of PET/CT was significantly better than combination tumor markers. Of 66 cases with available follow-up, isolated abdominal wall (port/scar site) recurrence and loco-regional recurrence demonstrated significantly higher post-recurrence survival as compared to distant metastasis; median survival being 39, 25 and 12 months, respectively.

Conclusion

F-18 FDG PET/CT has better diagnostic performance than tumor markers combination. Isolated abdominal wall (port/scar site) recurrence and loco-regional recurrence on PET/CT demonstrated better survival than non-regional metastatic disease. These results suggest a possible role of PET/CT as a surveillance modality, as well as a guide to therapeutic decision-making in cases of recurrent GBC.

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Availability of data and materials

Data that support the results of this study are available on request from corresponding author due to them containing information that could compromise patients’ privacy.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, E. Borges road, Parel, Mumbai, 400012, India

    Akshay S Bedmutha, Archi Agrawal, Venkatesh Rangarajan, Ameya D. Puranik, Nilendu C. Purandare, Sneha Shah & Sayak Choudhury

  2. Gastro-intestinal and Hepato-pancreato-biliary surgical service, Department of Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, E. Borges road, Parel, Mumbai, 400012, India

    Mahesh Goel & Shraddha Patkar

  3. Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, E. Borges road, Parel, Mumbai, 400012, India

    Mukta Ramadwar

Authors
  1. Akshay S Bedmutha
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  2. Archi Agrawal
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  3. Venkatesh Rangarajan
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  4. Mahesh Goel
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  6. Ameya D. Puranik
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  7. Mukta Ramadwar
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  8. Nilendu C. Purandare
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  9. Sneha Shah
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  10. Sayak Choudhury
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Contributions

All authors contributed to study conception and design. All authors read and approved the final manuscript. Conceptualization: AA, ASB, MG. Methodology: AA, ASB, ADP. Data collection: ASB, SC, SP, MR. Formal analysis: VR, ADP, SP. Original draft preparation: ASB, AA, VR. Review and editing: NCP, MG, SS. Supervision: AA, VR

Corresponding author

Correspondence to Archi Agrawal.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

The study was approved by Institutional Ethics Committee of Tata Memorial Centre, and was performed in accordance with ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Institutional Review Board number: 900692

Consent of participant

In view of retrospective nature of study including already available medical records, waiver of informed consent was approved by Institutional Ethics Committee. We declare that patients’ anonymity is completely preserved at all stages of the study.

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Bedmutha, A.S., Agrawal, A., Rangarajan, V. et al. Diagnostic performance of F-18 FDG PET/CT in recurrent adenocarcinoma gallbladder and its impact on post-recurrence survival. Jpn J Radiol 41, 201–208 (2023). https://doi.org/10.1007/s11604-022-01340-8

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  • DOI: https://doi.org/10.1007/s11604-022-01340-8

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