Molecular Imaging in Gallbladder and Biliary Tract Malignancies
PDF
Cite
Share
Request
Review
P: 181-186
July 2024

Molecular Imaging in Gallbladder and Biliary Tract Malignancies

Nucl Med Semin 2024;10(2):181-186
No information available.
No information available
Online Date: 31.07.2024
Publish Date: 31.07.2024
PDF
Cite
Share
Request

Abstract

The incidence of gallbladder cancer and biliary tract tumors has been increasing in recent years, with cholangiocarcinoma being the second most common primary liver malignancy. Accurate staging is crucial for determining the appropriate treatment strategy. Particularly in perihilar cholangiocarcinoma and infiltrative forms of biliary tract tumors, the sensitivity of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging for detecting primary lesions is not high and is not routinely recommended. FDG avidity may also be low in mucinous types of gallbladder cancers. Additionally, biliary stent placements and biliary infections can obscure cholangiocarcinoma foci or lead to false positive findings. However, in surgical candidates, PET/CT can be beneficial for ruling out distant metastases, evaluating suspicious findings in radiologic studies, assessing response to treatment in metastatic disease, and in cases of suspected recurrence. Although currently less accessible, studies have shown that PET/magnetic resonance imaging have identified additional findings that could alter patient management. Molecular imaging with Ga-68 fibroblast activation protein inhibitor, which targets the stromal component of the tumor microenvironment, has been found to have higher accuracy values than FDG for detecting both primary and metastatic lesions. This review discusses the role of molecular imaging in gallbladder and biliary tract tumors.

Keywords:
Gallbladder cancer
biliary tract cancer
F-18 FDG
Ga-68 FAPI
PET/CT

References

1
Lee Y, Yoo IR, Boo SH, Kim H, Park HL, Hyun O J. The Role of F-18 FDG PET/CT in Intrahepatic Cholangiocarcinoma. Nucl Med Mol Imaging. 2017;51:69-78.
2
Yoo C, Hyung J, Chan SL. Recent Advances in Systemic Therapy for Advanced Intrahepatic Cholangiocarcinoma. Liver Cancer. 2023;13:119-135.
3
Banales JM, Marin JJG, Lamarca A, et al. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol. 2020;17:557-588.
4
Chahinian R, El-Amine A, Matar S, Annan M, Shamseddine A, Haidar M. 68Ga-Prostate-Specific Membrane Antigen, A Potential Radiopharmaceutical in PET/CT To detect primary Cholangiocarcinoma. Asia Ocean J Nucl Med Biol. 2020;8:136-140.
5
Werner RA, Kircher S, Higuchi T, et al. CXCR4-Directed Imaging in Solid Tumors. Front Oncol. 2019;9:770.
6
Shin DW, Moon SH, Kim JH. Diagnosis of Cholangiocarcinoma. Diagnostics (Basel). 2023;13:233.
7
Pang L, Bo X, Wang J, et al. Role of dual-time point 18F-FDG PET/CT imaging in the primary diagnosis and staging of hilar cholangiocarcinoma. Abdom Radiol (NY). 2021;46:4138-4147.
8
Fritscher-Ravens A, Bohuslavizki KH, Broering DC, et al. FDG PET in the diagnosis of hilar cholangiocarcinoma. Nucl Med Commun. 2001;22:1277-1285.
9
Nishiyama Y, Yamamoto Y, Fukunaga K, et al. Dual-time-point 18F-FDG PET for the evaluation of gallbladder carcinoma. J Nucl Med. 2006;47:633-638.
10
Lamarca A, Barriuso J, Chander A, et al. 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) for patients with biliary tract cancer: Systematic review and meta-analysis. J Hepatol. 2019;71:115-129.
11
Corvera CU, Blumgart LH, Akhurst T, et al. 18F-fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer. J Am Coll Surg. 2008;206:57-65.
12
Ferrone C, Goyal L, Qadan M, et al. Management implications of fluorodeoxyglucose positron emission tomography/magnetic resonance in untreated intrahepatic cholangiocarcinoma. Eur J Nucl Med Mol Imaging. 2020;47:1871-1884.
13
Sahani DV, Hayano K, Galluzzo A, Zhu AX. Measuring treatment response to systemic therapy and predicting outcome in biliary tract cancer: comparing tumor size, volume, density, and metabolism. AJR Am J Roentgenol. 2015;204:776-781.
14
Kumar R, Sharma P, Kumari A, Halanaik D, Malhotra A. Role of 18F-FDG PET/CT in detecting recurrent gallbladder carcinoma. Clin Nucl Med. 2012;37:431-435.
15
Kitajima K, Murakami K, Kanegae K, et al. Clinical impact of whole body FDG-PET for recurrent biliary cancer: a multicenter study. Ann Nucl Med. 2009;23:709-715.
16
Giesel FL, Kratochwil C, Lindner T, et al. 68Ga-FAPI PET/CT: Biodistribution and Preliminary Dosimetry Estimate of 2 DOTA-Containing FAP-Targeting Agents in Patients with Various Cancers. J Nucl Med. 2019;60:386-392.
17
Guberina N, Kessler L, Pöttgen C, et al. [68Ga]FAPI-PET/CT for radiation therapy planning in biliary tract, pancreatic ductal adeno-, and adenoidcystic carcinomas. Sci Rep. 2022;12:16261.
18
Lan L, Zhang S, Xu T, et al. Prospective Comparison ofGa-FAPI versus F-FDG PET/CT for Tumor Staging in Biliary Tract Cancers. Radiology. 2022;304:648-657.
19
Pabst KM, Trajkovic-Arsic M, Cheung PFY, et al. Superior Tumor Detection for 68Ga-FAPI-46 Versus 18F-FDG PET/CT and Conventional CT in Patients with Cholangiocarcinoma. J Nucl Med. 2023;64:1049-1055.
20
Veldhuijzen van Zanten SEM, Pieterman KJ, Wijnhoven BPL, et al. FAPI PET versus FDG PET, CT or MRI for Staging Pancreatic-, Gastric- and Cholangiocarcinoma: Systematic Review and Head-to-Head Comparisons of Diagnostic Performances. Diagnostics (Basel). 2022;12:1958.