Elsevier

PET Clinics

Volume 10, Issue 3, July 2015, Pages 327-343
PET Clinics

FDG PET/CT in Pancreatic and Hepatobiliary Carcinomas: Value to Patient Management and Patient Outcomes

https://doi.org/10.1016/j.cpet.2015.03.001Get rights and content

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Key points

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    Fludeoxyglucose F 18 (18F-FDG) PET/CT has not been shown to offer additional benefit in the initial diagnosis of pancreatic cancer, but studies show benefit of 18F-FDG PET/CT in staging, particularly in the detection of distant metastasis, and in patient prognosis.

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    There is good evidence for 18F-FDG PET and 18F-FDG PET/CT in the staging and prognosis of both cholangiocarcinoma and gallbladder cancer.

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    18F-FDG PET/CT has shown promise in the staging of liver malignancies by detecting extrahepatic

Fludeoxyglucose F 18 PET/Computed Tomography in the Diagnosis of Pancreatic Cancer

As discussed previously, the guidelines by the NCCN and the American College of Radiology suggest CT as the reference standard for the diagnosis and initial management of pancreatic cancer. There is no consensus that 18F-FDG PET/CT is superior to CT in this regard, although debate exists. In 2014, a meta-analysis of 35 studies by Rijkers and colleagues20 calculated pooled sensitivity (SN), specificity (SP), positive predictive value, and negative predictive value of 90%, 76%, 90%, and 76%,

Fludeoxyglucose F 18 PET/computed tomography in staging and therapy planning of biliary tract cancers

TNM staging for cholangiocarcinoma and gallbladder cancer by the AJCC is again the most widely used staging system. Staging can dramatically alter the therapy plan for a patient. 18F-FDG PET and 18F-FDG PET/CT have shown added benefit to the staging of cholangiocarcinoma. 18F-FDG PET/CT is valuable in lymph node staging and in the detection of distant metastasis. In a prospective study by Kim and colleagues 2008,33 123 patients with suspected cholangiocarcinoma underwent work-up with

Fludeoxyglucose F 18 PET/computed tomography in staging and therapy planning of hepatocellular carcinoma

Current work-up for diagnosis and staging of HCC includes CT, MR imaging, chest CT, and bone scintigraphy, if clinically indicated.7 Although several staging systems exist, such as the Okuda system and Barcelona Clinic Liver Cancer classification,45, 46 the AJCC TNM staging remains the most widely accepted system. Over the course of a decade, 18F-FDG PET/CT has shown promise in the staging of liver malignancies by detecting extrahepatic metastasis. 18F-FDG PET alone has been found to offer

Summary

Although 18F-FDG PET/CT has not been shown to offer additional benefit in the initial diagnosis of pancreatic cancer, studies show benefit of 18F-FDG PET/CT in staging, particularly in the detection of distant metastasis, and patient prognosis. Likewise, there is good evidence for 18F-FDG PET and 18F-FDG PET/CT in the staging and prognosis of both cholangiocarcinoma and gallbladder cancer. 18F-FDG PET/CT has shown promise in the staging of liver malignancies by detecting extrahepatic

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    Disclosure: Dr Subramaniam – Phillips Health Care Molecular Imaging board meeting and Bayer Health Care – Clinical trials.

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