The Clinical Significance of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography in Patients with Occupational Cholangiocarcinoma

Document Type: Research Articles

Authors

1 Department of Hepato-Biliary-Pancreatic Surgery Osaka City University Graduate School of Medicine 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan

2 Department of Diagnostic Pathology, Fukui-ken Saiseikai Hospital, Funabashi 7-1, Wadanaka-cho, Fukui City, Fukui 918-8503 Japan

3 Department of Human Pathology, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa 920-8640, Japan

4 Department of Hepato-Biliary Pancreatic Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006,

5 Department of Hepato-Biliary-Pancreatic Surgery, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan

6 Department of Surgery, Ishikiriseiki Hospital, 18-28 Yayoicho, Higashi Osaka City, Osaka 579-8026, Japan

7 Department of Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata City, Osaka 573-1010, Japan

Abstract

Objective: The present study aimed to identify the clinical significance of fluorine-18 fluorodeoxyglucose positron
emission tomography (FDG-PET) imaging in patients with occupational cholangiocarcinoma. Methods: This study
included 10 men with occupational cholangiocarcinoma who were former or current workers at a printing company in
Osaka, Japan. Of the 10 patients, 2 had 2 main tumors and 1 had 3 main tumors. Twelve FDG-PET imaging findings
in the 10 patients could be analyzed. We evaluated the relationships between FDG-PET imaging parameters and
clinicopathological findings of occupational cholangiocarcinoma. Results: Abnormal FDG uptake was observed in 8 of
the 14 main tumors, with maximum standardized uptake values ranging from 2.9 to 11.0, and the sensitivity was 57.1%.
Four patients had lymph node metastases, and abnormal marrow uptake was detected in all these patients. Although
precancerous lesions, such as biliary intraepithelial neoplasia (BilIN) and intraductal papillary neoplasm of the bile
duct (IPNB) without any invasion, were not detected, abnormal FDG uptake was demonstrated in 2 of 4 patients with
IPNB having an associated invasive carcinoma.Conclusions: Although FDG-PET may be useful for assessing tumor
progression factors, such as lymph node metastasis, it cannot accurately detect precancerous lesions, such as BilIN
and IPNB without invasive carcinoma.

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