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KMID : 0371420221020060335
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Annals of Surgical Treatment and Research
2022 Volume.102 No. 6 p.335 ~ p.341
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Diagnostic and prognostic impact of fluorodeoxyglucose-positron emission tomography in diagnosing intraductal papillary neoplasms of the bile duct of the liver
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Choi Jin-Uk
Hwang Shin
Ahn Chul-Soo
Moon Deok-Bog
Ha Tae-Yong
Song Gi-Won
Jung Dong-Hwan
Kim Jae-Seung
Hong Seung-Mo
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Abstract
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Purpose: Malignant intraductal papillary neoplasm of the bile duct of the liver (IPNB-L) cannot readily be diagnosed through preoperative CT or MRI, but fluorodeoxyglucose (FDG)-PET is a viable alternative. This study evaluated the diagnostic and prognostic impacts of FDG-PET in patients with IPNB-L.
Methods: This was a retrospective single-center study of 101 IPNB-L patients who underwent hepatectomy between 2010 and 2019.
Results: Mean age was 64.4 ± 8.3 years and 76 (75.2%) were male. Anatomical hepatic resection was performed in 99 (98.0%). Concurrent bile duct resection and pancreaticoduodenectomy were performed in 41 (40.6%) and 1 (1.0%), respectively. R0 and R1 resections were performed in 88 (87.1%) and 13 (12.9%), respectively. Low-grade intraepithelial neoplasia and high-grade neoplasia/invasive carcinoma were diagnosed in 19 (18.8%) and 82 (81.2%), respectively. Median FDG-PET maximal standardized uptake values (SUVmax) in low-grade neoplasia and high-grade neoplasia/carcinoma were 3.6 (range, 1.7?7.6) and 5.2 (range, 1.5?18.7) (P = 0.019), respectively. Receiver operating characteristic curve analysis of SUVmax showed area under the curve of 0.674, with sensitivity of 84.2% and specificity of 47.4% at SUVmax cutoff of 3.0. This cutoff had no significant influence on tumor recurrence (P = 0.832) or patient survival (P = 0.996) in patients with IPNB-L of high-grade neoplasia or invasive carcinoma.
Conclusion: IPNB-L is a rare type of biliary neoplasm and encompasses a histological spectrum ranging from benign disease to invasive carcinoma. An FDG-PET SUVmax cutoff of 3.0 appears to effectively discern high-grade neoplasia/carcinoma from low-grade neoplasia, which will assist with the surgical strategy for these cases.
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KEYWORD
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Carcinoma, Dysplasia, Imaging study, Malignant transformation, Papillary growth
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