Sensitivity and specificity of FDG PET-CT scan in detecting lymph node metastasis in operable periampullary tumours in correlation with the final histopathology after curative surgery

Abstract

18F-Fluorodeoxyglucose-positron emission tomography/computerised tomography (FDG-PET/CT) was investigated for evaluation of periampullary tumours and other gastrointestinal neoplasms. The aim of this study was to evaluate the utility of FDG-PET/CT for detection of lymph node metastasis in periampullary tumours by comparing the preoperative FDG-PET/CT scan finding with postoperative histopathology of lymph nodes. Study was done on 24 patients with diagnosis of periampullary carcinoma either proven or suspected on conventional radiology. Standard uptake value (SUV) were measured for lymph node areas with uptake in FDG-PET/CT and compared with histopathological lymph node status. For detection of lymph node metastasis, FDG-PET/CT with cutoff value SUV max ≥2.0 had a sensitivity of 71.4 % and specificity of 77.8 % and that for SUV max ≥2.5 and 2.8 were 57.1, 42.9 and 77.8, 77.8 %, respectively. The sensitivity and specificity of FDG-PET/CT at each lymph node groups were 72 and 89 % in peripancreatic area, 100 and 93 % in hepatoduodenal area and 100 and 100 % in aortocaval area at SUV max ≥2.0, respectively. At SUV max ≥2.5 the values were 57 and 89 % in peripancreatic area, 100 and 93 % in hepatoduodenal area and 100 and 93 % in aortocaval area. FDG-PET-CT has a possible role in detection of lymph node metastasis in periampullary carcinomas and may be used as a guide for possible lymphadenectomy during surgery and for prognostic purpose.

Metabolic Characteristics of Advanced Biliary Tract Cancer Using 18F-Fluorodeoxyglucose Positron Emission Tomography and Their Clinical Implications

“…Most of the lesions were lymph node and bone metastasis. This is in accordance with previous reports about detection of L.N and the occult metastatic site of PET [22,31].…”

Combining endoscopic ultrasound and tumor markers improves the diagnostic yield on the etiology of common bile duct dilation secondary to periampullary pathologies

“…A total of 37 patients with periampullary tumors were included in our study, 18 of the tumors were found at ampulla of Vater and 19 were found at lower CBD. The accuracy of US, CT, MRI and PET-CT for differentiating between malignant and benign CBD dilation in this study were 70.2% (40/57), 70.3% (45/64), 66.7% (60/90), 65.2% (30/46), which were all significantly lower than what other literature reported (38)(39)(40)(41)(42)(43). For the difficult cases of periampullary tumor, the signs of EUS are more obvious than those of imaging.…”

Comparative Oncology: Evaluation of 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) for the Staging of Dogs with Malignant Tumors

“…Furthermore the SUV in the primary tumors was increased compared to the physiologic thoracic and abdominal organs (Table 4). As a rule, malignant tumors exhibit an increased SUV value, a cutoff value of >2.5 being described [29]. However, an increased SUV does not represent a diagnosis and certainly does not make any further elucidation unnecessary.…”