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Integrated vs standard imaging for gallbladder cancer staging

Positron emission with computed tomography detects distant metastases not diagnosed by standard imaging, and therefore has an important impact on therapy, report researchers in June's issue of Journal of Hepatology.

News image

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Dr Henrik Petoskey and colleagues from Switzerland evaluated the diagnostic value of integrated positron emission and computed tomography.

The researchers compared this technique with contrast-enhanced computed tomography in detecting biliary tract tumors and associated lymph node metastases.

The team also evaluated the impact of positron emission/computed tomography on therapy management.

The team performed the procedures from 2001 to 2005.

Each patient who was treated for a malignancy of the biliary tract underwent positron emission/computed tomography in addition to the standard imaging.

Data were prospectively collected and analyzed in comparison with contrast-enhanced computed tomography.

The researchers included 61 patients with malignancies of the biliary tract in the study.

Diagnosis was proven in all patients either by histology or cytology.

Positron emission/computed tomography detected all gallbladder cancers, of which there were 14.

The team noted that both techniques provided a comparable accuracy for the 14 primary intra- and 33 extra-hepatic cholangiocarcinomas.

All 12 distant metastases were detected by positron emission/computed tomography
Journal of Hepatology

All 12 distant metastases were detected by positron emission/computed tomography.

However, the researchers observed that only 3 distant metastases were detected by contrast-enhanced computed tomography.

This difference was significant.

Regional lymph node metastases were detected by positron emission/computed tomography and contrast-enhanced computed tomography in only 12% vs 24%.

The team found that positron emission/computed tomography findings changed management in 17% of patients deemed resectable after standard work-up.

Dr Petrowsky's team concluded, “Positron emission/computed tomography is particularly valuable in detecting unsuspected distant metastases which are not diagnosed by standard imaging.”

“Thus, positron emission/computed tomography staging has an important impact on selection of adequate therapy.”

J Hepatol 2006: 45(1): 43-5
21 June 2006

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