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.”