Background: Radical re-resection is offered to patients with non-metastatic, invasive, incidental gallbladder cancer. Data evaluating (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in patients with incidental gallbladder cancer is sparse.
Aim: To evaluate the efficacy of integrated (18)F-FDG PET-CT in determining occult metastatic or residual local-regional disease in patients with incidental gallbladder cancer.
Methods: Patients referred with incidental gallbladder cancer for radical re-resection were evaluated using multidetector computed tomography (MDCT) and PET-CT. Based on preoperative imaging, 24 out of 92 patients were found suitable for surgery. The two imaging modalities were evaluated with respect to residual and resectable disease.
Results: In determining residual disease, MDCT had a sensitivity and positive predictive value (PPV) of 42.8%, each, while PET-CT had a sensitivity and PPV of 28.5 and 20%, respectively. In determining resectability, MDCT had a sensitivity, PPV, and accuracy of 100, 87.5, and 87.5%, respectively, as compared to PET-CT (sensitivity=100%, PPV=91.3%, accuracy=91.6%).
Conclusions: From our study, it appears that in patients with incidental gall bladder cancer without metastatic disease, PET-CT and MDCT seem to have roles complementing each other. PET-CT was able to detect occult metastatic or residual local-regional disease in some of these patients, and seems to be useful in the preoperative diagnostic algorithm of patients whose MDCT is normal or indicates locally advanced disease.
Keywords: PET–CT; gallbladder; imaging; incidental.