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18F-FDG PET/CT in differentiating malignant from benign origins of obstructive jaundice |
Shao-Bo Wang, Hu-Bing Wu, Quan-Shi Wang, Wen-Lan Zhou, Ying Tian, Yun-Hai Ji and Liang Lv |
Guangzhou, China
Author Affiliations: Nanfang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China (Wang SB, Wu HB, Wang QS, Zhou WL and Tian Y); Department of Radiology, First People's Hospital of Yunnan Province, Kunming 650000, China (Wang SB, Ji YH and Lv L)
Corresponding Author: Quan-Shi Wang, MD, PhD, Professor, Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou 510515, China (Tel/Fax: +86-20-61642127; Email: wqslph@163.net) |
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Abstract BACKGROUND: The various origins of obstructive jaundice make the diagnosis of the disease difficult. This study was undertaken to evaluate the role of 18F-FDG PET/CT in differentiating malignant from benign origins of obstructive jaundice and to quantify the added value of 18F-FDG PET/CT over conventional imaging (enhanced CT and/or MRI).
METHODS: Eighty-five patients with obstructive jaundice who underwent 18F-FDG PET/CT within 2 weeks after enhanced CT and/or MRI were reviewed retrospectively. All 18F-FDG PET/CT images were independently evaluated by 2 nuclear medicine physicians who were unaware of other imaging data; differences were resolved by consensus of the physicians. All conventional imaging interpretations, according to the medical records, were reviewed by 2 radiologists to determine the potential value. Final diagnoses were based on histological or surgical findings.
RESULTS: Sixty-six patients were diagnosed with malignancies, and 19 patients with benign lesions. The maximum standardized uptake values for malignant and benign lesions causing biliary obstruction were 8.2±4.4 and 4.0±5.0, respectively (P<0.05). The sensitivity, specificity, and overall accuracy for differentiating malignant from benign origins with 18F-FDG PET/CT were 86.4% (57/66), 73.7% (14/19), and 83.5% (71/85), respectively. 18F-FDG PET/CT in conjunction with conventional imaging changed the sensitivity, specificity, and overall accuracy of conventional imaging alone from 75.8% (50/66) to 95.5% (63/66) (P<0.05), 68.4% (13/19) to 57.9% (11/19) (P>0.05), and 74.1% (63/85) to 87.1% (74/85) (P<0.05), respectively.
CONCLUSIONS: 18F-FDG PET/CT is of great value in differentiating malignant from benign origins of obstructive jaundice and is a useful adjuvant to conventional imaging. 18F-FDG PET/CT should be recommended for further etiological clarification.
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