Role of Positron Emission Tomography- Contrast Enhanced Computed Tomography (PETCECT) in locally advanced gallbladder cancer.

This study aims to define the role of 18F -FDG (Flurodeoxyglucose) PETCECT (Positron emission tomography Contrast Enhanced Computed tomography) scan in upstaging disease in patients with locally advanced gallbladder cancer (LAGBC).

An analysis of a prospectively maintained database of gallbladder cancer (GBC) patients was performed. Patients found to have locally advanced (T3 and/or T4 or N+) but non-metastatic disease on initial imaging, either a Contrast Enhanced Computed Tomography (CECT) or a Magnetic Resonance Imaging (MRI) scan, underwent an additional PETCECT for staging and the results impacting treatment decision were recorded.

One hundred and three patients of LAGBC underwent CECT/MRI and PETCECT. 48/103 (46.6%) were found to be upstaged to stage IV after PETCECT. The most common metastatic site was non regional retroperitoneal lymph nodes (12 patients, 11.7%) followed by satellite lesions in liver (11, 10.7%). 14 (13.6%) patients had equivocal findings on PET scan that required confirmation by tissue sampling out of which 10 (71.4%) were subsequently found to have metastatic disease. The only statistically significant factor predicting distant spread on PETCECT was the presence of loco-regional nodes on CT scan (Odds ratio 6.15, p 0.006).

PETCECT is a valuable tool to rule out metastatic disease in patients presenting with LAGBC.

Journal of hepato-biliary-pancreatic sciences. 2020 Jan 16 [Epub ahead of print]

Shraddha Patkar, Aditi Chaturvedi, Mahesh Goel, Venkatesh Rangarajan, Ashutosh Sharma, Reena Engineer

Gastrointestinal and Hepatopancreaticobiliary services, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai., Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai., Department of Radiation Oncology, Tata Memorial Hospital, Mumbai.