1. Preoperative staging of hilar cholangiocarcinoma by dual-modality PET/CT. DR SIKANDAR YASHODA HOSPITALS HYDERABAD

2. PURPOSE: To evaluate the accuracy of (18)F-FDG PET/CT in staging hilar cholangiocarcinoma

3. MATERIALS AND METHODS: From January 2006 to March 2010,34 patients were evaluated for surgical treatment of hilar cholangiocarcinoma were entered into a retrospective study. Dual modality (18)F-FDG PET/CT was performed before surgery for staging after injecting the 18F FDG and subsequent scanning after 60 minutes first by CT followed by PET. The study findings were compared to the operative and pathological results in each case for tumor-node-metastasis staging.

4. RESULTS: Thirty four patients (12 women, 22 men) of a median age of 59 years were included in the study. Radical tumour resection was performed on fourteen patients. Twenty patients underwent surgical exploration.

5. The sensitivity of PET/CT in detecting primary tumor was found to be 58.8% (25% in T2 tumor, 70% in T3 tumor, 66.7% in T4 tumor). The sensitivity/specificity of PET/CT in detecting lymph node metastasis and distant metastasis were 41.7%/80% and 55.6%/87.5%, respectively. Positive (18)F-FDG uptake in the bile duct was found to be associated with surgical non-resectability (P = 0.05).

6. Cholangiocarcinoma with liver metastases

7. Post whipples procedure,liver and lung mets

8. Post whipples periportal node

9. Cholangiocarcinoma with liver infiltration and local nodes

10. Cholangiocarcinoma infiltration into gall bladder

11. Cholangiocarcinoma with extensive mets

12. Post op cholangiocarcinoma

13. Post CBD stenting

14. Terminal CBD cholangiocarcinoma

15. Cholangiocarcinoma with peritoneal mets

16. Malignant CBD stricture

17. Cholangiocarcinoma

18. Periampullary carcinoma

19. CONCLUSION: Dual-modality PET/CT imaging was found to have a high specificity in detection of lymph node and distant metastasis in hilar cholangiocarcinoma, with a limited value in correct judgment of surgical respectability for tumors

20. drsikandar_s@yahoo.co.in