Journal Article

Management implications of fluorodeoxyglucose positron emission tomography/magnetic resonance in untreated intrahepatic cholangiocarcinoma

Zhu, Andrew X, Catana Ciprian, Domachevsky Liran, Canamaque, Lina G, Ferrone, Cristina, Hong, Theodore S, Catalano, Onofrio A, Gervais, Debra, Sahani, Dushyant V, Groshar, David, Bernstine, Hanna H, Li, Yan, Qadan Motaz, Pandharipande, Pari V, Herrmann, Ken, Amorim, Barbara J, Tanabe, Kenneth K, Vangel, Mark, Collazo, Yolanda Q, Umar, Mahmood, Goyal Lipika, Shih, Tiffany Tsing-Fang, Duenas, Virginia P, Rosen, Bruce R, Wo, Jennifer Y, Blaszkowsky, Lawrence S, Umutlu Lale

2020

Overview

PurposeIntrahepatic cholangiocarcinoma (ICC) is associated with a poor prognosis with surgical resection offering the best chance for long-term survival and potential cure. However, in up to 36% of patients who undergo surgery, more extensive disease is found at time of operation requiring cancellation of surgery. PET/MR is a novel hybrid technology that might improve local and whole-body staging in ICC patients, potentially influencing clinical management. This study was aimed to investigate the possible management implications of PET/MR, relative to conventional imaging, in patients affected by untreated intrahepatic cholangiocarcinoma.MethodsRetrospective review of the clinicopathologic features of 37 patients with iCCC, who underwent PET/MR between September 2015 and August 2018, was performed to investigate the management implications that PET/MR had exerted on the affected patients, relative to conventional imaging.ResultsOf the 37 patients enrolled, median age 63.5 years, 20 (54%) were female. The same day PET/CT was performed in 26 patients. All patients were iCCC-treatment-naïve. Conventional imaging obtained as part of routine clinical care demonstrated early-stage resectable disease for 15 patients and advanced stage disease beyond the scope of surgical resection for 22. PET/MR modified the clinical management of 11/37 (29.7%) patients: for 5 patients (13.5%), the operation was cancelled due to identification of additional disease, while 4 “inoperable” patients (10.8%) underwent an operation. An additional 2 patients (5.4%) had a significant change in their operative plan based on PET/MR.ConclusionsWhen compared with standard imaging, PET/MR significantly influenced the treatment plan in 29.7% of patients with iCCC.Trial registration2018P001334

• Publisher: Springer Nature B.V
• Subject: Cholangiocarcinoma / Computed tomography / Health services / Magnetic resonance imaging / Management / Medical imaging / Medical prognosis / Patients / Positron emission / Positron emission tomography / Surgery / Tomography