Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 015] Diagnostic and prognostic impact of fluorodeoxyglucose-positron emission tomography in diagnosing intraductal papillary neoplasms of the bile duct of the liver
Shin HWANG*1 , Jin Uk CHOI1 , Chul-Soo AHN1 , Deok-Bog MOON1 , Tae-Yong HA1 , Gi-Won SONG1 , Dong-Hwan JUNG1 , Jae Seung KIM2 , Seung-Mo HONG3
1 Department Of Surgery, Asan Medical Center, University Of Ulsan College Of Medicine, REPUBLIC OF KOREA
2 Department Of Nuclear Medicine, Asan Medical Center, University Of Ulsan College Of Medicine, REPUBLIC OF KOREA
3 Department Of Pathology, Asan Medical Center, University Of Ulsan College Of Medicine, REPUBLIC OF KOREA
Background : Malignant intraductal papillary neoplasm of the bile duct of the liver (IPNB-L) cannot readily be diagnosed through preoperative computed tomography or magnetic resonance imaging, but fluorodeoxyglucose-positron emission tomography (FDG-PET) is a viable alternative. This study evaluated the diagnostic and prognostic impacts of FDG-PET in patients with IPNB-L.
Methods : This was a retrospective single-center study of 101 IPNB-L patients who underwent hepatectomy between 2010 and 2019.
Results : Mean age was 64.4?.3 years and 76 (75.2%) were male. Anatomical hepatic resection was performed in 99 (98.0%). Concurrent bile duct resection and pancreaticoduodenectomy were performed in 41 (40.1%) and 1 (1.0%), respectively. R0 and R1 resections were performed in 88 (87.1%) and 13 (12.9%), respectively. Low-grade intraepithelial neoplasia and high-grade neoplasia/invasive carcinoma were diagnosed in 19 (18.8%) and 82 (81.2%), respectively. Median FDG-PET maximal standardized uptake values (SUVmax) in low-grade neoplasia and high-grade neoplasia/carcinoma were 3.6 (range: 1.7-7.6) and 5.2 (range: 1.5?18.7; p=0.019), respectively. Receiver operating characteristic curve analysis of SUVmax showed area under the curve of 0.674, with sensitivity of 84.2% and specificity of 47.4% at SUVmax cutoff of 3.0. This cutoff had no significant influence on tumor recurrence (p=0.832) or patient survival (p=0.996) in patients with IPNB-L of high-grade neoplasia or invasive carcinoma
Conclusions : IPNB-L is a rare type of biliary neoplasm and encompasses a histological spectrum ranging from benign disease to invasive carcinoma. An FDG-PET SUVmax cutoff of 3.0 appears to effectively discern high-grade neoplasia/carcinoma from low-grade neoplasia, which will assist with the surgical strategy for these cases.
Methods : This was a retrospective single-center study of 101 IPNB-L patients who underwent hepatectomy between 2010 and 2019.
Results : Mean age was 64.4?.3 years and 76 (75.2%) were male. Anatomical hepatic resection was performed in 99 (98.0%). Concurrent bile duct resection and pancreaticoduodenectomy were performed in 41 (40.1%) and 1 (1.0%), respectively. R0 and R1 resections were performed in 88 (87.1%) and 13 (12.9%), respectively. Low-grade intraepithelial neoplasia and high-grade neoplasia/invasive carcinoma were diagnosed in 19 (18.8%) and 82 (81.2%), respectively. Median FDG-PET maximal standardized uptake values (SUVmax) in low-grade neoplasia and high-grade neoplasia/carcinoma were 3.6 (range: 1.7-7.6) and 5.2 (range: 1.5?18.7; p=0.019), respectively. Receiver operating characteristic curve analysis of SUVmax showed area under the curve of 0.674, with sensitivity of 84.2% and specificity of 47.4% at SUVmax cutoff of 3.0. This cutoff had no significant influence on tumor recurrence (p=0.832) or patient survival (p=0.996) in patients with IPNB-L of high-grade neoplasia or invasive carcinoma
Conclusions : IPNB-L is a rare type of biliary neoplasm and encompasses a histological spectrum ranging from benign disease to invasive carcinoma. An FDG-PET SUVmax cutoff of 3.0 appears to effectively discern high-grade neoplasia/carcinoma from low-grade neoplasia, which will assist with the surgical strategy for these cases.
SESSION
E-poster
E-Session 03/03 ~ 03/05 ALL DAY