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Risk stratification of gallbladder polyps (1-2 cm) for surgical intervention with 18F-FDG PET/CT

 Jaehoon Lee  ;  Mijin Yun  ;  Kyoung-Sik Kim  ;  Jong-Doo Lee  ;  Chun K. Kim 
 JOURNAL OF NUCLEAR MEDICINE, Vol.53(3) : 353-358, 2012 
Journal Title
Issue Date
Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/pathology ; Adenoma/diagnostic imaging ; Adenoma/pathology ; Adult ; Aged ; Cell Transformation, Neoplastic/pathology ; False Positive Reactions ; Female ; Fluorodeoxyglucose F18* ; Gallbladder Diseases/diagnostic imaging* ; Gallbladder Diseases/pathology ; Gallbladder Diseases/surgery* ; Gallbladder Neoplasms/diagnostic imaging* ; Gallbladder Neoplasms/pathology ; Gallbladder Neoplasms/surgery* ; Gallstones/diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Polyps/diagnostic imaging* ; Polyps/pathology ; Polyps/surgery* ; Positron-Emission Tomography/methods* ; Predictive Value of Tests ; ROC Curve ; Radiopharmaceuticals* ; Retrospective Studies ; Risk Assessment ; Tomography, Emission-Computed/methods*
gallbladder polyp ; gallbladder cancer ; polypoid lesion of gallbladder ; PET ; fluorodeoxyglucose
We assessed the value of (18)F-FDG uptake in the gallbladder polyp (GP) in risk stratification for surgical intervention and the optimal cutoff level of the parameters derived from GP (18)F-FDG uptake for differentiating malignant from benign etiologies in a select, homogeneous group of patients with 1- to 2-cm GPs. METHODS: Fifty patients with 1- to 2-cm GPs incidentally found on the CT portion of PET/CT were retrospectively analyzed. All patients had histologic diagnoses. GP (18)F-FDG activity was visually scored positive (≥liver) or negative (<liver). Maximal standardized uptake value of the GP (SUVgp) and ratio of SUVgp to mean SUV of the liver (GP/L ratio) were also measured. Univariate and multivariate logistic regression analyses were performed to determine the utility of patient and clinical variables--that is, sex, age, gallstone, polyp size, and three (18)F-FDG-related parameters in risk stratification. RESULTS: Twenty GPs were classified as malignant and 30 as benign. Multivariate analyses showed that the age and all parameters (visual criteria, SUVgp, and GP/L) related to (18)F-FDG uptake were significant risk factors, with the GP/L being the most significant. The sex, size of GPs, and presence of concurrent gallstones were found to be insignificant. CONCLUSION: (18)F-FDG uptake in a GP is a strong risk factor that can be used to determine the necessity of surgical intervention more effectively than other known risk factors. However, all criteria derived from (18)F-FDG uptake presented in this series may be applicable to the assessment of 1- to 2-cm GPs.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0002-9898-9886
Lee, Jong Doo(이종두)
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