J Korean Soc Radiol.  2011 Aug;65(2):161-166. 10.3348/jksr.2011.65.2.161.

Clinical Usefulness of 18F 2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Scan in the Diagnosis of Ampullary Carcinoma

• Nam SJ
• Chung JJ
• Kim DJ
• Cho ES
• Ahn JH
• Kim JH
• Yu JS

• KMID: 1443480
• DOI: http://doi.org/10.3348/jksr.2011.65.2.161

Abstract

PURPOSE
To evaluate the clinical usefulness of the 18F 2-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET) scan in the diagnosis of the ampulla of Vater cancer.
MATERIALS AND METHODS
CT images of 39 patients with ampulla of Vater cancer were reviewed regarding the lesion size, location, and bile or pancreatic duct dilatation. The patients were divided into three groups according to the lesion visibility on CT (Group A: visible mass, Group B: no visible mass but prominent ampulla, Group C: no visible lesion). Standardized uptake value (SUV) was measured on PET scan and the detection rate on PET images was comparable with that of CT images.
RESULTS
Twenty-four patients (61.5%) were classified as Group A, 11 (28.2%) as Group B and 4 (10.3%) as Group C. All of Group A, 10 (90.9%) of Group B and 3 (75.0%) of Group C showed biliary dilatation. Pancreatic duct dilatation was shown in 18 (75.0%) of Group A, 9 (81.8%) of Group B, and 1 (25.0%) of Group C. The average of SUV of all patients was 5.90 +/- 3.1. Most (94.9%) of all patients showed high FDG uptake over 2.5 with 93.9% in Group B and C.
CONCLUSION
18F-FDG PET scan was use for the detection of ampulla of Vater cancer, even though the lesion was invisible on CT.

MeSH Terms

Ampulla of Vater
Bile
Dilatation
Duodenum
Electrons
Fluorodeoxyglucose F18
Humans
Pancreatic Ducts
Positron-Emission Tomography
Fluorodeoxyglucose F18

Figure

• 

  Fig. 1 A 69-year-old female patient with ampullary carcinoma (Group A). A, B. On axial and coronal CT images, about 1.6 cm sized ill-defined fungating mass lesion is well seen at the ampulla of Vater. C. There is high FDG uptake on 18F-FDG PET scan, showing SUV 8.4. After surgery, the lesion is confirmed as an adenocarcinoma, well differentiated type. Note.-FDG = 2-fluoro-2-deoxy-D-glucose, PET = positron emission tomography, SUV = standardized uptake value

• 

  Fig. 2 A 65-year-old female patient with ampullary carcinoma (Group B). A, B. On axial and coronal CT images, only prominent papilla is seen with mild dilatation of common bile duct without definite visible mass lesion. C. On 18F-FDG PET images, there is FDG uptake of SUV 11.0, suggesting malignant lesion. On ERCP, there is 1.3 m sized adenocarcinoma, moderate differentiated type arising from ampulla of Vater was confirmed. Note.-ERCP = endoscopic retrograde cholangiopancreatography, SUV = standardized uptake value, 18F-FDG PET = 18F 2-fluoro-2-deoxy-D-glucose positron emission tomography

• 

  Fig. 3 A 75-year-old male patient with ampullary carcinoma (Group C). A, B. There is no visible abnormality at the periampullary area without pancreatic duct or bile duct dilatation. C. Focal high FDG uptake is noted on 18F-FDG PET scan, showing SUV 5.2. D. After Whipple's operation, the lesion is confirmed as an adenocarcinoma, moderately differentiated type. Note.-FDG = 2-fluoro-2-deoxy-D-glucose, PET = positron emission tomography, SUV = standardized uptake value

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