Diagnostic value of FDG-PET for lymph node metastasis and outcome of surgery for biliary cancer

Shogo Kobayashi, Hiroaki Nagano, Hiromitsu Hoshino, Hiroshi Wada, Shigeru Marubashi, Hidetoshi Eguchi, Yutaka Takeda, Masahiro Tanemura, Tonsok Kim, Eku Shimosegawa, Jun Hatazawa, Yuichiro Doki, Masaki Mori

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background and Objectives: Histopathologically confirmed lymph node metastasis is a prognostic factor in the surgical treatment of biliary tract cancer, however, preoperative diagnosis is still difficult even with computed tomography. FDG-PET has been used for the diagnosis of cancer and metastatic lesions. Herein, we retrospectively evaluated the utility of FDG-PET for detection of lymph node metastasis in biliary tract cancer. Methods: We measured SUVmax at each 190 surgically dissected lymph node area in 36 patients, and compared the values with histopathological diagnosis. The cutoff values for SUVmax were defined from the ROC curve and the mean plus two standard deviations then used for detection of metastatic lymph node and prognostic value, compared with CT diagnosis. Results: The sensitivity, specificity, and positive predictive value of FDG-PET were better than CT diagnosis (86%, 74%, 43% for SUVmax ≥ 2.0, and 37%, 97%, 72% for SUVmax ≥ 2.8, respectively). There was no relationship between SUVmax and CT-determined lymph node dimensions. The presence of SUVmax ≥ 2.8 lymph nodes was an independent determinant of prognosis after surgical treatment. Conclusion: The detection of metastatic lymph nodes by FDG-PETis limited, but better than CT. SUVmax for lymph nodes seems useful for clinical decision-making regarding treatment strategy including surgery.

Original languageEnglish
Pages (from-to)223-229
Number of pages7
JournalJournal of Surgical Oncology
Volume103
Issue number3
DOIs
Publication statusPublished - Mar 1 2011

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Biliary Tract Neoplasms
Lymph Nodes
Neoplasm Metastasis
ROC Curve
Therapeutics
Tomography
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Diagnostic value of FDG-PET for lymph node metastasis and outcome of surgery for biliary cancer. / Kobayashi, Shogo; Nagano, Hiroaki; Hoshino, Hiromitsu; Wada, Hiroshi; Marubashi, Shigeru; Eguchi, Hidetoshi; Takeda, Yutaka; Tanemura, Masahiro; Kim, Tonsok; Shimosegawa, Eku; Hatazawa, Jun; Doki, Yuichiro; Mori, Masaki.

In: Journal of Surgical Oncology, Vol. 103, No. 3, 01.03.2011, p. 223-229.

Research output: Contribution to journalArticle

Kobayashi, S, Nagano, H, Hoshino, H, Wada, H, Marubashi, S, Eguchi, H, Takeda, Y, Tanemura, M, Kim, T, Shimosegawa, E, Hatazawa, J, Doki, Y & Mori, M 2011, 'Diagnostic value of FDG-PET for lymph node metastasis and outcome of surgery for biliary cancer', Journal of Surgical Oncology, vol. 103, no. 3, pp. 223-229. https://doi.org/10.1002/jso.21811
Kobayashi, Shogo ; Nagano, Hiroaki ; Hoshino, Hiromitsu ; Wada, Hiroshi ; Marubashi, Shigeru ; Eguchi, Hidetoshi ; Takeda, Yutaka ; Tanemura, Masahiro ; Kim, Tonsok ; Shimosegawa, Eku ; Hatazawa, Jun ; Doki, Yuichiro ; Mori, Masaki. / Diagnostic value of FDG-PET for lymph node metastasis and outcome of surgery for biliary cancer. In: Journal of Surgical Oncology. 2011 ; Vol. 103, No. 3. pp. 223-229.
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abstract = "Background and Objectives: Histopathologically confirmed lymph node metastasis is a prognostic factor in the surgical treatment of biliary tract cancer, however, preoperative diagnosis is still difficult even with computed tomography. FDG-PET has been used for the diagnosis of cancer and metastatic lesions. Herein, we retrospectively evaluated the utility of FDG-PET for detection of lymph node metastasis in biliary tract cancer. Methods: We measured SUVmax at each 190 surgically dissected lymph node area in 36 patients, and compared the values with histopathological diagnosis. The cutoff values for SUVmax were defined from the ROC curve and the mean plus two standard deviations then used for detection of metastatic lymph node and prognostic value, compared with CT diagnosis. Results: The sensitivity, specificity, and positive predictive value of FDG-PET were better than CT diagnosis (86{\%}, 74{\%}, 43{\%} for SUVmax ≥ 2.0, and 37{\%}, 97{\%}, 72{\%} for SUVmax ≥ 2.8, respectively). There was no relationship between SUVmax and CT-determined lymph node dimensions. The presence of SUVmax ≥ 2.8 lymph nodes was an independent determinant of prognosis after surgical treatment. Conclusion: The detection of metastatic lymph nodes by FDG-PETis limited, but better than CT. SUVmax for lymph nodes seems useful for clinical decision-making regarding treatment strategy including surgery.",
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