Positron-emission tomography with fluorine-18-fluoro-2-deoxy-D-glucose for gallbladder cancer diagnosis

Port site and distant metastases of gallbladder cancer after laparoscopic cholecystectomy diagnosed by positron emission tomography

“…FDG is a glucose analogue that is phosphorylated in the cells, but not further metabolized. Most malignant tumors show increased uptake of FDG because malignant transformation and growth of tumor cells is associated with overexpression of glucose transporters and increased hexokinase activity [4] . FDG-PET imaging has been increasingly used to identify and stage various tumors.…”

“…This has been particularly notable in the evaluation of recurrent or metastatic disease [5][6][7] . A few studies have evaluated the use of FDG-PET in the assessment of biliary system tumors or gallbladder carcinoma [4,[8][9][10] . In the study of Anderson et al, nine of 14 gallbladder cancer patients had residual carcinoma at the time of PET [9] .…”

“…In diabetic patients, the rate of FDG accumulation in the tumor is decreased, impaired the sensitivity of FDG-PET [10] . In patients with mucinous adenocarcinoma of the gallbladder, a false-negative result has also been reported, probably secondary to poor cellular density [4] . To increase the sensitivity for small lesions, the underestimation due to the partial-volume effect may be reduced by improving the spatial resolution of PET; movement artifacts may be reduced by breath gating of the measurement, and by avoiding reintroduction of the patient to the scanner; PET scanning can be well performed under optimal conditions.…”

“…Anderson et al [9] report that the sensitivity of this modality was 78% in their series of 14 gallbladder cancer cases. In the study of Antonio et al, which comprises a series of 16 patients, FDG-PET showed a sensitivity of 0.80, a specificity of 0.82 in diagnosing gallbladder cancer [4] . These studies revealed that FDG-PET can provide important information for establishing the nature of gallbladder lesions especially when in conjunction with conventional modalities.…”

“…The most common reason for false positive FDG-PETs is an inflammatory lesion. Xanthogranulomatous cholecystitis and polypoid lesion with adenomyomatosis are also the common reasons caused false positive result [4,10,11] . PET imaging must be interpreted with caution in patients with known severe inflammatory or granulomatous disease.…”