Published in:
01-06-2015
Diagnostic accuracy of F-18 FDG PET/CECT vs. CECT for detecting recurrence of periampullary carcinoma and its prognostic significance
Published in: Abdominal Radiology | Issue 5/2015
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Purpose
To evaluate the additive value of whole-body F-18 fluoro-deoxyglucose positron emission tomography (FDG PET) as an adjunct to contrast-enhanced computed tomography (CECT) for detecting recurrence following Whipple’s resection for periampullary carcinoma and to analyze the prognostic significance of FDG PET-/CECT-based detection of recurrence.
Methods
Fifty patients (34 males, 16 females; mean age: 55 ± 11 years) who underwent PET/CECT following resection of periampullary carcinoma were included. The study was duly approved by the institutional ethical committee for retrospective analysis of the data. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of FDG PET/CECT and CECT alone for detection of recurrence were calculated, and the accuracy was compared with ROC analysis. The prognostic factors for survival following recurrence were analyzed by univariate and multivariate methods.
Results
PET/CECT indicated recurrence of disease in 26 (52%) patients. The overall mean survival time was 46 months with an overall survival rate of 42%. The sensitivity, specificity, PPV, NPV and accuracy of PET/CECT and CECT for detection of recurrence were 96.1%, 91.6%, 92.6%, 95.6%, 94% and 76.9%, 75%, 76.9%, 75%, 76%, respectively (p = 0.037). Also change in management could have been achieved in 18% of patients based on the PET/CECT results. In univariate analyses, SUVmax >7.3 was the only predictor of poor survival (p < 0.05).
Conclusion
PET/CECT could be used as a one-stop imaging tool for staging and prognostication of recurrent periampullary carcinoma that could result in better patient management.