18F-FDG PET/CT in differentiating malignant from benign origins of obstructive jaundice

• Published in: Hepatobiliary & pancreatic diseases international Vol. 14; no. 5; pp. 516 - 522
• Main Authors: Wang, Shao-Bo, Wu, Hu-Bing, Wang, Quan-Shi, Zhou, Wen-Lan, Tian, Ying, Ji, Yun-Hai, Lv, Liang
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01.10.2015
• Subjects: Aged; Bile Ducts - pathology; Carcinoma - complications; Carcinoma - diagnosis; Cholecystitis - complications; Cholecystitis - diagnosis; Choledocholithiasis - complications; Choledocholithiasis - diagnosis; computed tomography; Constriction, Pathologic - complications; Constriction, Pathologic - diagnosis; CT检查; Digestive System Neoplasms - complications; Digestive System Neoplasms - diagnosis; False Negative Reactions; False Positive Reactions; Female; fluorodeoxyglucose; Fluorodeoxyglucose F18; Humans; Jaundice, Obstructive - etiology; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging; obstructive jaundice; Pancreatitis - complications; Pancreatitis - diagnosis; PET; positron emission tomography/computed tomography; Positron-Emission Tomography - methods; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed; 影像学; 恶性肿瘤; 起源; 鉴别诊断; 阻性; 黄疸; computed tomography; positron emission tomography/computed tomography; magnetic resonance imaging; fluorodeoxyglucose; obstructive jaundice
• ISSN: 1499-3872
• DOI: 10.1016/S1499-3872(15)60392-7

The various origins of obstructive jaundice make the diagnosis of the disease difficult. This study was undertaken to evaluate the role of 18F-FDG PET/CT in differentiating malignant from benign origins of obstructive jaundice and to quantify the added value of 18F-FDG PET/CT over conventional imaging (enhanced CT and/or MRI). Eighty-five patients with obstructive jaundice who underwent 18F-FDG PET/CT within 2 weeks after enhanced CT and/or MRI were reviewed retrospectively. All 18F-FDG PET/CT images were independently evaluated by 2 nuclear medicine physicians who were unaware of other imaging data; differences were resolved by consensus of the physicians. All conventional imaging interpretations, according to the medical records, were reviewed by 2 radiologists to determine the potential value. Final diagnoses were based on histological or surgical findings. Sixty-six patients were diagnosed with malignancies, and 19 patients with benign lesions. The maximum standardized uptake values for malignant and benign lesions causing biliary obstruction were 8.2±4.4 and 4.0±5.0, respectively (P<0.05). The sensitivity, specificity, and overall accuracy for differentiating malignant from benign origins with 18F-FDG PET/CT were 86.4% (57/66), 73.7% (14/19), and 83.5% (71/85), respectively. 18F-FDG PET/CT in conjunction with conventional imaging changed the sensitivity, specificity, and overall accuracy of conventional imaging alone from 75.8% (50/66) to 95.5% (63/66) (P<0.05), 68.4% (13/19) to 57.9% (11/19) (P>0.05), and 74.1% (63/85) to 87.1% (74/85) (P<0.05), respectively. 18F-FDG PET/CT is of great value in differentiating malignant from benign origins of obstructive jaundice and is a useful adjuvant to conventional imaging. 18F-FDG PET/CT should be recommended for further etiological clarification.