PT  - JOURNAL ARTICLE
AU  - Michael J. Reinhardt
AU  - Holger Strunk
AU  - Thomas Gerhardt
AU  - Roland Roedel
AU  - Ursula Jaeger
AU  - Jan Bucerius
AU  - Tilman Sauerbruch
AU  - Hans-Juergen Biersack
AU  - Franz L. Dumoulin
TI  - Detection of Klatskin’s Tumor in Extrahepatic Bile Duct Strictures Using Delayed <sup>18</sup>F-FDG PET/CT: Preliminary Results for 22 Patient Studies
DP  - 2005 Jul 01
TA  - Journal of Nuclear Medicine
PG  - 1158--1163
VI  - 46
IP  - 7
4099  - http://jnm.snmjournals.org/content/46/7/1158.short
4100  - http://jnm.snmjournals.org/content/46/7/1158.full
SO  - J Nucl Med2005 Jul 01; 46
AB  - Detection of cholangiocarcinoma in extrahepatic bile duct strictures is a continuing challenge in clinical practice because brush cytology taken at endoscopic retrograde cholangiography has an average sensitivity of 50%. The aim of this study was to evaluate the effectiveness of dual-modality PET/CT using 18F-FDG for noninvasive differentiation of extrahepatic bile duct strictures. Methods: Twenty-two PET/CT studies were performed on 20 patients (10 women, 10 men; mean age ± SD, 63 ± 14 y) with extrahepatic bile duct strictures on endoscopic retrograde cholangiography. PET imaging was started 101 ± 22 min after injection of 369 ± 48 MBq of 18F-FDG. Blood glucose was 100 ± 20 mg/dL. PET images were reconstructed iteratively with attenuation correction based on a rescaling of the CT image. CT was performed within 1 min before the PET study, with the patient in the same position. CT was used to place a volume of interest 5 cm in diameter at the liver hilus for quantitative evaluation of PET images by means of standardized uptake values (SUVs). Results: Final diagnosis was histologically proven cholangiocarcinoma in 14 cases and benign causes of strictures in 8 cases without evidence of malignancy during a follow-up of 18 ± 3 mo. All patients with cholangiocarcinoma presented with focal increased uptake in the liver hilus with an SUV of 6.8 ± 3.3 (range, 3.9–15.8), compared with 2.9 ± 0.3 (range, 2.5–3.3) in patients with benign causes of strictures (P = 0.003). There was a clear cutoff SUV of 3.6 for detection of malignancy in the liver hilus. Conclusion: 18F-FDG PET/CT provided high accuracy for noninvasive detection of perihilar cholangiocarcinoma in extrahepatic bile duct strictures.