F-18 FDG PET/CT Imaging in Diagnosis and Staging of Gallbladder Adenocarcinoma-Case Report
Date Issued
2019
Author(s)
Beshliev, Simon
Todorova Stefanovski, Dusica
Tasevski, Slavko
Angjeleska, Meri
Abstract
Aim: To present a case with suspected gallbladder cancer where 18-FDG
PET/CT proved to be useful imaging modality for the diagnosis and staging.
Method: Fifty seven years old female was referred to PET/CT scan due to
inconclusive findings from ultrasonography (US), computed tomography
(CT), an magnetic resonance imaging (MRI) and core biopsy of the liver.
Pathohistological examination of the tumor mass in the liver confirmed
hepatic metastasis from unknown origin. PET/CT scan was performed from
the vertex of the skull to the toe, 3 minutes per bad on a SIMENS Biograph
40 PET/CT one hour after intravenous administration of 347Mbq of F-18 FDG
with low dose CT scan without intravenous or gastrointestinal contrast. Prescan
level of glucose was 5.1 mmol/L. The maximum standard uptake value
(SUVmax) measured 3.9 in the region of the liver (segment VI).
Results: A PET/CT scan demonstrated increased FDG uptake (SUVmax=11.3) in
a hypodense unhomogenous mass that involved the gallbladder and the
liver in segment IV/VIII. Two metabolically active focuses (SUVmax=4.3) were
detected in the liver in the segment III and VI and two enlarged nodules near
the pancreatic head (SUVmax=4.3).
Conclusion: The PET/CT confirmed the suspected diagnosis of gallbladder
cancer and because of the spread in the liver and lymph nodes surgery
was not performed. Gallbladder cancer is a rare malignancy that grows
rapidly with local invasion into the liver and with distant spread to lymph
nodes. Despite the routine use of ultrasonography, computed tomography
and magnetic imaging, in this case report, PET/CT scan proved to be very
useful due to its capability of whole body imaging and possibility of showing
additional lesions and providing optimal pre-treatment staging in patient
that allowed appropriate treatment plan to be tailored.
PET/CT proved to be useful imaging modality for the diagnosis and staging.
Method: Fifty seven years old female was referred to PET/CT scan due to
inconclusive findings from ultrasonography (US), computed tomography
(CT), an magnetic resonance imaging (MRI) and core biopsy of the liver.
Pathohistological examination of the tumor mass in the liver confirmed
hepatic metastasis from unknown origin. PET/CT scan was performed from
the vertex of the skull to the toe, 3 minutes per bad on a SIMENS Biograph
40 PET/CT one hour after intravenous administration of 347Mbq of F-18 FDG
with low dose CT scan without intravenous or gastrointestinal contrast. Prescan
level of glucose was 5.1 mmol/L. The maximum standard uptake value
(SUVmax) measured 3.9 in the region of the liver (segment VI).
Results: A PET/CT scan demonstrated increased FDG uptake (SUVmax=11.3) in
a hypodense unhomogenous mass that involved the gallbladder and the
liver in segment IV/VIII. Two metabolically active focuses (SUVmax=4.3) were
detected in the liver in the segment III and VI and two enlarged nodules near
the pancreatic head (SUVmax=4.3).
Conclusion: The PET/CT confirmed the suspected diagnosis of gallbladder
cancer and because of the spread in the liver and lymph nodes surgery
was not performed. Gallbladder cancer is a rare malignancy that grows
rapidly with local invasion into the liver and with distant spread to lymph
nodes. Despite the routine use of ultrasonography, computed tomography
and magnetic imaging, in this case report, PET/CT scan proved to be very
useful due to its capability of whole body imaging and possibility of showing
additional lesions and providing optimal pre-treatment staging in patient
that allowed appropriate treatment plan to be tailored.
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