Pathways of lymph node involvement in upper abdominal malignancies: evaluation with high-resolution CT

Efremidis, Stavros C.; Vougiouklis, Nikolaos; Zafiriadou, E.; Sofianou, F; Sbarounis, C N; Fardellas, Y; K, Patsiaura; Leontsini, Maria

doi:10.1007/s003300050757

Cited by 16 publications

(8 citation statements)

References 9 publications

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“…It can also reveal the presence of hepatic and peritoneal metastases and lymphatic dissemination [17,46]. Infiltrated lymph nodes usually have an anteroposterior diameter of >1 cm and are ring-shaped with heterogeneous uptake after contrast administration [48,49]. Using these criteria, the sensitivity for detection of the different lymph node chains ranges from 0.18 for interaorticocaval nodes to 0.78 for the right celiac chain.…”

Section: Ct In Gbcmentioning

confidence: 98%

Application of modern imaging methods in diagnosis of gallbladder cancer

Rodrı́guez-Fernández

Gómez-Río

Medina-Benítez

et al. 2006

Journal of Surgical Oncology

103

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The poor prognosis of gallbladder cancer (GBC) is related to its dissemination capacity and usually late diagnosis due to its non-specific clinical appearance. Recent improvements in hepatobiliary surgery have underlined the importance of an early specific diagnosis, which requires a multidisciplinary approach and, when possible, specialized equipment. The first step in an early diagnosis is to identify patients in the appropriate epidemiological setting (e.g., incidental finding, chronic cholecystitis) for the correct interpretation of test results. It is desirable to enhance the sensitivity of the initial ultrasound (US) examination by use of the appropriate technology in skilled specialist hands. When GBC is suggested by US findings, FDG-PET can be considered complementary to establish the benign/malignant nature of the lesion and to obtain a primary staging study. If GBC is confirmed, thin slice spiral CT can contribute valuable information on local spread. In this regard, recent hybrid PET-CT systems provide structural and functional information simultaneously and may offer early and accurate T, N, and M staging with an improved specificity.

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Section: Ct In Gbcmentioning

confidence: 98%

Application of modern imaging methods in diagnosis of gallbladder cancer

Rodrı́guez-Fernández

Gómez-Río

Medina-Benítez

et al. 2006

Journal of Surgical Oncology

103

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“…However, our data also suggest that thoracic nodal involvement constitutes a significant site of organ metastasis (63 thoracic nodes, 72 abdominal nodes). Lymphatic spread from the liver, as one of the upper gastrointestinal malignancies, follows a specific pathway of drainage through the lesser omentum to the retroperitoneal space, to the hepatoduodenal, peripancreatic, and aortocaval nodes (19). Lymphatic spread may also ascend within the retroperitoneal space along the aortocaval chain to the subphrenic and thoracic nodal basins.…”

Section: Individual Organ Metastasismentioning

confidence: 99%

Dual-Tracer PET/CT Imaging in Evaluation of Metastatic Hepatocellular Carcinoma

Ho¹,

Chen²,

Yeung³

et al. 2007

Journal of Nuclear Medicine

190

140

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We have reported previously that 11 C-acetate ( 11 C-ACT) PET was complementary to 18 F-FDG PET in the evaluation of primary hepatocellular carcinoma (HCC) in relation to the degree of tumor cellular differentiation. In this retrospective study, our goals were to further explore the complementary role of 11 C-ACT and 18 F-FDG PET in the detection of metastatic HCC disease, to evaluate the tracer characteristics of individual organ metastasis, to identify the risk factors of metastasis, and to evaluate how these results could affect patient management. Methods: One hundred twenty-one patients were selected for this study. All patients had undergone a ''dual-tracer'' PET/CT same-day protocol with 11 C-ACT PET/CT followed by 18 F-FDG PET/CT. Sets of criteria were chosen to define ''metastasis'' and ''no metastasis'' on a patient basis. The patients considered as truepositive (n 5 97) were then divided into 4 groups on the basis of their primary HCC tracer avidity: 18 F-FDG-avid group, 11 C-ACT-avid group, 18 F-FDG-and 11 C-ACT-avid group, and a posttreatment group with metastasis but no baseline dual-tracer PET characterization of the primary tumor and no hepatic recurrence. Results: On a patient basis, dual-tracer PET/CT had a sensitivity of 98%, a specificity of 86%, a positive predictive value of 97%, a negative predictive value of 90%, and an accuracy of 96% in the detection of HCC metastasis. On a lesion basis, 273 metastatic HCC lesions considered as true-positive were detected and categorized according to the organ or site of metastasis: lymph node (abdominal and thoracic, 49%), lung (32%), bone (8%), and others (10%). The lesion-based and patientbased detection sensitivities were 60% and 64%, respectively, by 11 C-ACT and 77% and 79%, respectively, by 18 F-FDG, and they were complementary. In analyzing lesion tracer avidity, there was a positive statistical correlation between primary HCC avidity with the general tendency of metastasis. Clinically significant changes in management were found in patients with true-positive metastasis, of whom 19% were affected by 11 C-ACT PET alone. Dual-tracer PET/CT was more effective than single-tracer PET/CT in identifying candidates for curative therapy (negative predictive value of dual-tracer, 18 F-FDG, and 11 C-ACT PET/CT: 90%, 49%, and 37%, respectively). Conclusion: This study confirmed that 18 F-FDG PET/CT is useful in the evaluation of HCC metastasis, although its role in the diagnosis of primary HCC is more limited. Dual-tracer PET/CT had an incremental value and complementary advantage when compared with single-tracer imaging in the evaluation of HCC metastasis.

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“…High positive predictive value of CT means that it is useful for determining resectability and assisting treatment planning [25]. Infiltrated lymph nodes are > 1cm, ring shaped with heterogeneous uptake after contrast administration [26]. Pericholedochal nodes are most frequently involved followed by cystic nodes [12].…”

Section: Discussionmentioning

confidence: 99%

Bony Secondaries and Dissemination in Advance Carcinoma Gallbladder: A Longitudinal Study

Dd¹

2018

CRIJ

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Context: Metastasis in carcinoma gall bladder is uncommon and occurs late in the course of the disease. Of all the distant sites that can be involved, the skeletal system is the least common site. We hereby present a prospective longitudinal study depicting the incidence, type, predisposing site and time of presentation of skeletal metastasis in carcinoma gallbladder. Aims: The present study provides new and important information regarding skeletal metastases which may be more common with the introduction of laparoscopic cholecystectomy and should be excluded before radical resection is contemplated.

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Pathways of lymph node involvement in upper abdominal malignancies: evaluation with high-resolution CT

Cited by 16 publications

References 9 publications

Application of modern imaging methods in diagnosis of gallbladder cancer

Application of modern imaging methods in diagnosis of gallbladder cancer

Dual-Tracer PET/CT Imaging in Evaluation of Metastatic Hepatocellular Carcinoma

Bony Secondaries and Dissemination in Advance Carcinoma Gallbladder: A Longitudinal Study

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