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Diagnostic performance of contrast enhanced CT and 18F-FDG PET/CT in suspicious recurrence of biliary tract cancer after curative resection
- Source :
- BMC Cancer, BMC Cancer, Vol 11, Iss 1, p 188 (2011)
- Publication Year :
- 2011
- Publisher :
- BioMed Central, 2011.
-
Abstract
- Background Because of the late clinical presentation of biliary tract cancer (BTC), only 10% of patients are eligible for curative surgery. Even among those patients who have undergone curative surgery, most patients develop recurrent cancer. This study is to determine the clinical role of 18F-FDG PET/CT during post-operative surveillance of suspected recurrent BTC based on symptoms, laboratory findings and contrast-enhanced CT (ceCT) findings. Methods We consecutively enrolled 50 patients with BTC who underwent curative surgery. An 18F-FDG PET/CT was obtained for assessment of recurrence based on clinical suspicion during post-operative surveillance. The final confirmation of recurrence was determined pathologically or clinically. When a pathologic confirmation was impossible or inconclusive, a clinical confirmation was used by radiologic correlation with subsequent follow-up ceCT at a minimum of 3-month intervals. Diagnostic efficacy was evaluated by comparing the results of ceCT and 18F-FDG PET/CT with the final diagnosis. Results Among the 50 patients, 34(68%) were confirmed to have a recurrence. PET/CT showed higher sensitivity (88% vs. 76%, p = 0.16) and accuracy (82% vs. 66%, p = 0.11) for recurrence compared to ceCT, even though the difference was not significant. The positive (86% vs. 74%, p = 0.72) and negative predictive values for recurrence (73% vs. 47%, p = 0.55) were not significantly different between PET/CT and ceCT. However, an additional PET/CT on ceCT significantly improved the sensitivity than did a ceCT alone (94% [32/34] for PET/CT on ceCT vs. 76% [26/34] for ceCT alone, p = 0.03) without increasing the specificity, positive predictive value, and negative predictive value. Conclusions 18F-FDG PET/CT alone is not more sensitive or specific than ceCT in the detection of recurrent BTC after curative surgery. These results do not reach statistical significance, probably due to the low number of patients. However, an additional 18F-FDG PET/CT on ceCT significantly improves the sensitivity of detecting recurrences.
- Subjects :
- 18F-FDG PET/CT
Adult
Male
Cancer Research
medicine.medical_specialty
recurrence
Enhanced ct
lcsh:RC254-282
Sensitivity and Specificity
Text mining
Surgical oncology
Fluorodeoxyglucose F18
Statistical significance
biliary tract cancer
Genetics
Biomarkers, Tumor
Medicine
Humans
Aged
Biliary tract neoplasm
Biliary tract cancer
medicine.diagnostic_test
business.industry
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Biliary Tract Neoplasms
Oncology
ROC Curve
Positron emission tomography
Positron-Emission Tomography
surveillance
Fdg pet ct
Female
Radiology
Neoplasm Recurrence, Local
business
Tomography, X-Ray Computed
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712407
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- BMC Cancer
- Accession number :
- edsair.doi.dedup.....a93b3a68eeed16816e228af7c8209809