Distinguishing benign from malignant gallbladder wall thickening using FDG-PET

Oe, Ai; Kawabe, Joji; Torii, Koji; Kawamura, Etsushi; Higashiyama, Shigeki; Kotani, Jin; Hayashi, Takuo; Kurooka, Hiroko; Tsumoto, Chikako; Kubo, Shoji; Shiomi, Susumu

doi:10.1007/bf02984683

Cited by 59 publications

(23 citation statements)

References 18 publications

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“…Some false-positive FDG-PET cases have been reported that described FDG accumulations on the gallbladder wall were observed in cases of chronic cholecystitis [16], the gallbladder tuberculosis [17], xanthogranulomatous cholecystitis [14] and Mirrizi syndrome [15]. In these cases, it appears that differentiating gallbladder cancer from benign gallbladder diseases which also exhibit wall thickness with long-term and/or extreme inflammation is very difficult.…”

Section: Discussionmentioning

confidence: 95%

Successful Diagnosis of Gallbladder Carcinoma Coexisting with Adenomyomatosis by 18F-FDG-PET—Report of a Case

Suzuki

Watada

Mitsui

et al. 2010

J Gastrointest Canc

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Section: Discussionmentioning

confidence: 95%

Successful Diagnosis of Gallbladder Carcinoma Coexisting with Adenomyomatosis by 18F-FDG-PET—Report of a Case

Suzuki

Watada

Mitsui

et al. 2010

J Gastrointest Canc

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“…10 Gallbladder wall thickening is a nonspecific finding associated with many of these gallbladder diseases; however, the ability of F-18 FDG PET to distinguish between benign and malignant thickening has been incompletely evaluated in only a limited number of patients. 11 Uptake in the gallbladder wall may not always be related to an intrinsic gallbladder process, as rim-like FDG uptake in the gallbladder wall has been reported secondary to cholestasis/common bile duct obstruction related to a pancreatic mass. 12 Both benign and neoplastic entities can be FDG avid.…”

Section: Discussionmentioning

confidence: 98%

False Positive Diagnosis of Metastatic Esophageal Carcinoma on Positron Emission Tomography

Hansen

Brown

Khan

et al. 2010

Clinical Nuclear Medicine

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Esophageal cancer has been increasing in incidence for the last several decades. The current staging evaluation includes computed tomography, endoscopic ultrasonography, and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), which influences the treatment options. PET/CT is limited in its ability to differentiate hypermetabolic metastatic disease from acute/chronic inflammatory conditions, and this must be considered during interpretation. This is the case report of a 77-year-old man with esophageal cancer whose PET/CT demonstrated increased F-18 FDG uptake in the right lobe of the liver. This was originally interpreted at an outside institution as suspicious for metastatic disease, which would have precluded potential surgical cure. Subsequent reinterpretation and additional imaging including magnetic resonance imaging suggested that the uptake in the liver was likely due to adjacent gallbladder inflammation. On the basis of this interpretation, an abdominal exploration, liver biopsy, cholecystectomy, and transhiatal esophagectomy were performed. Final pathology of the gallbladder revealed perforated cholecystitis and a pericholecystic abscess (related to a prior septic episode), which were responsible for the increased radiotracer uptake. This case is presented to illustrate the importance of considering benign etiologies that may mimic metastatic disease when interpreting PET/CT scans.

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“…[12][13][14] Many studies have evaluated the preoperative imaging diagnosis of gallbladder cancer, and reported that its differentiation from benign gallbladder diseases, such as cholecystitis and gallbladder adenomyoma, poses a diagnostic challenge. [15][16][17][18][19][20][21] On the other hand, previous studies have reported the preoperative diagnosis of gallbladder cancer by bile cytology. Recent studies have reported patients who underwent ultrasoundguided fine-needle aspiration cytology (FNAC) and achieved favorable results with a minimal risk of complications.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of lavage cytology during endoscopic transpapillary catheterization into the gallbladder in the cytological diagnosis of gallbladder disease

Naito

Okabe

Kawahara

et al. 2009

Diagnostic Cytopathology

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Many studies have reported methods of cell collection involving percutaneous transhepatic cholangiodrainage (PTCD) and fine-needle aspiration cytology for the diagnosis of gallbladder disease. However, few studies have described the use of a transpapillary approach, i.e., endoscopic transpapillary catheterization into the gallbladder (ETCG). In this study, we analyzed cells collected by ETCG to evaluate its usefulness in the cytological diagnosis of gallbladder disease. The subjects were 19 patients who had undergone ETCG for the diagnosis of gallbladder disease. Of these patients, 11 and 8 had gallbladder cancer and benign gallbladder disease, respectively. We also evaluated the diagnostic accuracy of PTCD cytology performed in 15 patients with gallbladder cancer.Specimens were cytologically diagnosed as normal or benign, indeterminate, suspected malignancy, malignant, and inadequate in 47% (9/19), 11% (2/19), 0% (0/19), 37% (7/19), and 5% (1/19) of patients, respectively. Specimens were diagnosed as malignant, indeterminate, normal or benign, and inadequate in 7, 2, 1, and 1, respectively, of the 11 patients diagnosed with gallbladder cancer. The sensitivity and specificity of ETCG cytology were 78 and 100%, respectively, whereas the diagnostic accuracy of PTCD cytology was 20% (3/15). None of the patients developed complications of ETCG. Despite its technical difficulty, ETCG for bile cytology allows the collection of adequate cell numbers from patients with benign disease or gallbladder cancer and facilitates a cytological diagnosis, making it a useful method for collecting cells.

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Distinguishing benign from malignant gallbladder wall thickening using FDG-PET

Abstract: FDG-PET appears able to distinguish between benign and malignant gallbladder wall thickening.

Cited by 59 publications

References 18 publications

Successful Diagnosis of Gallbladder Carcinoma Coexisting with Adenomyomatosis by 18F-FDG-PET—Report of a Case

Successful Diagnosis of Gallbladder Carcinoma Coexisting with Adenomyomatosis by 18F-FDG-PET—Report of a Case

False Positive Diagnosis of Metastatic Esophageal Carcinoma on Positron Emission Tomography

Usefulness of lavage cytology during endoscopic transpapillary catheterization into the gallbladder in the cytological diagnosis of gallbladder disease

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