Diagnostic and Prognostic Role of 18‐FDG PET/CT in the Management of Resectable Biliary Tract Cancer

Wing, Ka; Cheung, Tan To; She, Wong Hoi; Chok, Kenneth S. H.; Chan, Albert; Dai, Wing Chiu; Chiu, Wan Hang Keith; Lo, Chung Mau

doi:10.1007/s00268-017-4192-3

Cited by 47 publications

(28 citation statements)

References 49 publications

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“…Very few studies assessed the role of FDG-PET for the evaluation of nodal status, and no recommendations can be drawn because of conflicting results. 19 Given the high prognostic impact of positive lymph nodes in patients with large tumour burden or at increased surgical risk, preoperative endoscopic ultrasound with fine needle aspiration cytology may be considered to drive clinical decisions. Lymph node metastases beyond the hepato-duodenal and gastro-hepatic ligaments are a well-established contraindication to surgical resection.…”

Section: Clinical Diagnosis and General Principles Of Surgical Considmentioning

confidence: 99%

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Mazzaferro

Gorgen

Roayaie

et al. 2020

Journal of Hepatology

219

182

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The incidence of intrahepatic cholangiocarcinoma (iCCA) is increasing worldwide. Although several advances have been made in the past decades to better understand this complex malignancy and to develop new treatment strategies, the prognosis of iCCA remains dismal. Liver resection (LR) is the mainstay of treatment but only a minority of patients are amenable to surgery. In most cases, patients with iCCA will require a major hepatectomy for complete resection of the tumour. This may be contraindicated or increase the surgical burden in patients with chronic liver disease and small remnant liver volume. Lymphadenectomy with a minimal harvest of 6 lymph nodes is considered adequate, as microscopic nodal metastases have been shown in more than 40% of patients. Current 5-year overall survival following LR is in the range of 25%-40%. For locally advanced disease not amenable to upfront LR, neoadjuvant locoregional therapies may be used with the aim of converting these patients to resectability or even to transplantation in well-selected cases. Recent studies have shown that liver transplantation (LT) might be a treatment option for patients with unresectable very-early iCCA (i.e. < − 2 cm), with survival outcomes comparable to those of hepatocellular carcinoma. In patients with unresectable, advanced tumours, confined to the liver who achieve sustained response to neoadjuvant treatment, LT may be considered an option within prospective protocols. The role of adjuvant therapies in iCCA is still under debate. Herein, we review the recent advances in the surgical treatment of iCCA and examine its correlation with locoregional therapies, adjuvant and neo-adjuvant strategies.

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Section: Clinical Diagnosis and General Principles Of Surgical Considmentioning

confidence: 99%

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Mazzaferro

Gorgen

Roayaie

et al. 2020

Journal of Hepatology

219

182

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“…13,15 Recent data have suggested that standard uptake max may have prognostic implications and cut-offs may be able to distinguish between benign and malignant strictures among those with and without PSC. 16,17 Larger cohorts comprised of PSC patients are needed to determine if these observations can be applied in this unique population. Among these modalities, MRI/MRC is the diagnostic technique of choice.…”

Section: Noninvasive Imagingmentioning

confidence: 99%

Emerging Technologies for the Diagnosis of Perihilar Cholangiocarcinoma

et al. 2018

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The diagnosis of malignant biliary strictures remains problematic, especially in the perihilar region and in primary sclerosing cholangitis (PSC). Conventional cytology obtained during endoscopic retrograde cholangiography (ERC)-guided brushings of biliary strictures is suboptimal due to limited sensitivity, albeit it remains the gold standard with a high specificity. Emerging technologies are being developed and validated to address this pressing unmet patient need. Such technologies include enhanced visualization of the biliary tree by cholangioscopy, intraductal ultrasound, and confocal laser endomicroscopy. Conventional cytology can be aided by employing complementary and advanced cytologic techniques such as fluorescent in situ hybridization (FISH), and this technique should be widely adapted. Interrogation of bile and serum by examining extracellular vesicle number and cargo, and exploiting next-generation sequencing and proteomic technologies, is also being explored. Examination of circulating cell-free deoxyribonucleic acid (cfDNA) for differentially methylated regions is a promising test which is being rigorously validated. The special expertise required for these analyses has to date hampered their validation and adaptation. Herein, we will review these emerging technologies to inform the reader of the progress made and encourage further studies, as well as adaptation of validated approaches.

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“…F-18-FDG PET/BT gastrointestinal sistem kanserlerinde evreleme, hastalık rekkürensini saptama ve lezyonların benign-malign ayrımı gibi endikasyonlarla kullanılmaktadır. Yakın zamanda yapılmış çalışmada F-18-FDG PET/BT tetkiki safra yolları kanserlerinde tedavi planını yaparken lenf nodu metastazını belirlemede güvenilir olmasının yanısıra SUV max değerinin bağımsız prognostik faktör olduğunu göstermiştir (10). Vakamız F-18-FDG PET-BT'sinde ana hepatik safra kanalından koledoka 43 milimetrelik segment boyunca uzanan, en geniş yerinde 7 milimetreye ulaşan duvar kalınlaşması alanında malignite düzeyinde artmış (SUV max=6,1) FDG tutulumu saptanması nedeni ile kolanjiokarsinom öntanısı ile tarafımıza refere edilmişti.…”

Section: Discussionunclassified

F-18-FDG PET/BT’de kolanjiosellüler kanseri taklit eden Fasciola hepatica vakası

Kaçmaz

Tuncel

Ebik

et al. 2018

Endoskopi Gastrointestinal

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İnsan fasioliazisi, Fasciola hepatica ve Fasciola gigantica’nın neden olduğu, dünya genelinde nadir görülen zoonotik bir hastalıktır. Genellikle çiftlik hayvanlarını etkileyen bir trematod olup insan rastlantısal ara konakçıdır. Spesifik olmayan semptom ve bulgularının birçok hepatobiliyer hastalıkta izlenebilmesi nedeniyle fasioliazisin tanı ve tedavisi gecikebilmektedir. Elli üç yaşında kadın hasta 18-Florodeoksi-glukoz pozitron emisyon bilgisayaralı tomo-grafi incelemesinde ekstrahepatik safra yollarında yüksek florodeoksi-glukoz tutulumu nedeniyle kliniğimize başvurdu. Hastada son 3 aydır süren karın ağrısı, kaşıntı ve halsizlik yakınmaları mevcuttu. Kolanjiyosellüler kanseri taklit eden ve serolojik olarak tanısı konan biliyer fasioliazisli bu vakayı sunacağız.

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Diagnostic and Prognostic Role of 18‐FDG PET/CT in the Management of Resectable Biliary Tract Cancer

Cited by 47 publications

References 49 publications

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Emerging Technologies for the Diagnosis of Perihilar Cholangiocarcinoma

F-18-FDG PET/BT’de kolanjiosellüler kanseri taklit eden Fasciola hepatica vakası

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