RESUMEN
A patient with intrahepatic cholangiocarcinoma who underwent hepatic resection with completed neoadjuvant chemotherapy presented with increased CEA levels. Previous whole abdominal and chest CT scan revealed no evidence of local recurrence or metastasis. 68Ga-FAPI-46 PET showed significantly higher tumor-to-background contrast of recurrent tumor and nodal metastasis, which were undetectable in the FDG PET or conventional CT scan. These findings changed patient management. Larger studies with histopathological correlation and comparisons with other imaging modalities are required to validate the diagnostic performance. Moreover, a cystic lesion with FAPI uptake at the neck to the proximal body of the pancreas without FDG uptake is also incidentally noted. Differential diagnoses include sided branch IPMN and serous cystadenoma.
RESUMEN
Objective[s]: this study aimed to compare the diagnostic values of 11C-choline and 18F-fluorodeoxyglucose [18F-FDG] positron emission tomography/computed tomography [PET/CT] in patients with cholangiocarcinoma [CCA]
Methods: this prospective study was conducted on 10 patients [6 males and 4 females], aged 42-69 years, suspected of having CCA based on CT or magnetic resonance imaging [MRI] Results. 11C-choline and 18F-FDG PET/CT studies were performed in all patients over 1 week. PET/CT results were visually analyzed by 2 independent nuclear medicine physicians and quantitatively by calculating the tumor-to-background ratio [T/B]
Results: no 11C-choline PET/CT uptake was observed in primary extrahepatic or intrahepatic CCA cases. Intense 18F-FDG avidity was detected in the tumors of 8 patients [%80]. Two patients, who were 18F-FDG negative, had primary extrahepatic CCA. Ki-67 measurements were positive in all patients [range; 14.2%-39.9%]. The average T/B values of 11C-choline and 18F-FDG were 0.4 +/- 0.2 and 2.0 +/- 1.0 in all cases of primary CCA, respectively; these values were significantly lower for 11C-choline [P<0.005]. Both FDG and 11C-choline PET/CT detected metastatic CCA foci in all 8 patients [two patients had no metastases]
Conclusion: as the results suggested, primary CCA lesions showed a poor avidity for 11C-choline, whereas 18F-FDG PET/CT was of value for the detection of most primary CCA cases. In contrast to primary lesions, metastatic CCA lesions showed 11C-choline avidity
RESUMEN
Diagnostic nuclear medicine is being increasingly employed in clinical practice with the advent of new technologies and radiopharmaceuticals. The report of the prevalence of a certain disease is important for assessing the quality of that article. Therefore, this study was performed to evaluate the quality of published nuclear medicine articles and determine the frequency of reporting the prevalence of studied diseases. We used Standards for Reporting of Diagnostic Accuracy [STARD] and Quality Assessment of Diagnostic Accuracy Studies [QUADAS-2] checklists for evaluating the quality of articles published in five nuclear medicine journals with the highest impact factors in 2012. The articles were retrieved from Scopus database and were selected and assessed independently by two nuclear medicine physicians. Decision concerning equivocal data was made by consensus between the reviewers. The average STARD score was approximately 17 points, and the highest score was 17.19 +/- 2.38 obtained by the European Journal of Nuclear Medicine. QUADAS-2 tool showed that all journals had low bias regarding study population. The Journal of Nuclear Medicine had the highest score in terms of index test, reference standard, and time interval. Lack of clarity regarding the index test, reference standard, and time interval was frequently observed in all journals including Clinical Nuclear Medicine, in which 64% of the studies were unclear regarding the index test. Journal of Nuclear Cardiology had the highest number of articles with appropriate reference standard [83.3%], though it had the lowest frequency of reporting disease prevalence [zero reports]. All five journals had the same STARD score, while index test, reference standard, and time interval were very unclear according to QUADAS-2 tool. Unfortunately, data were too limited to determine which journal had the lowest risk of bias. In fact, it is the author's responsibility to provide details of research methodology so that the reader can assess the quality of research articles. Five nuclear medicine journals with the highest impact factor were comparable in terms of STARD score, although they all showed lack of clarity regarding index test, reference standard, and time interval, according to QUADAS-2. The current data were too limited to determine the journal with the lowest bias. Thus, a comprehensive overview of the research methodology of each article is of paramount importance to enable the reader to assess the quality of articles