Korean J Gastroenterol.  2013 Oct;62(4):227-233. 10.4166/kjg.2013.62.4.227.

Primary Tumor Maximum Standardized Uptake Value Measured on 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Is a Prognostic Value for Survival in Bile Duct and Gallbladder Cancer

  • 1Department of Internal Medicine, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hongjoo3.kim@samsung.com


Few studies have assessed the prognostic value of the primary tumor maximum standardized uptake value (SUVmax) measured by 2-[18F]-fluoro-2-deoxy-D-glucose PET-CT for patients with bile duct and gallbladder cancer.
A retrospective analysis of 61 patients with confirmed bile duct and gallbladder cancer who underwent FDG PET-CT in Kangbuk Samsung Medical Center (Seoul, Korea) from April 2008 to April 2011. Prognostic significance of SUVmax and other clinicopathological variables was assessed.
Twenty-three patients were diagnosed as common bile duct cancer, 17 as hilar bile duct cancer, 12 as intrahepatic bile duct cancer, and nine as gallbladder cancer. In univariate analysis, diagnosis of intrahepatic cholangiocarcinoma and gallbladder cancer, mass forming type, poorly differentiated cell type, nonsurgical treatment, advanced American Joint Committee on Cancer (AJCC) staging and primary tumor SUVmax were significant predictors of poor overall survival. In multivariate analysis adjusted for age and sex, primary tumor SUVmax (hazard ratio [HR], 4.526; 95% CI, 1.813-11.299), advanced AJCC staging (HR, 4.843; 95% CI, 1.760-13.328), and nonsurgical treatment (HR, 6.029; 95% CI, 1.989-18.271) were independently associated with poor overall survival.
Primary tumor SUVmax measured by FDG PET-CT is an independent and significant prognostic factor for overall survival in bile duct and gallbladder cancer.


Prognosis; Fluorodeoxyglucose F18; Positron-emission tomography and computed tomography; Bile duct neoplasms; Gallbladder neoplasms

MeSH Terms

Bile Duct Neoplasms/*diagnosis/mortality/radionuclide imaging
Cholangiocarcinoma/diagnosis/mortality/radionuclide imaging
Fluorodeoxyglucose F18/diagnostic use/metabolism/standards
Gallbladder Neoplasms/*diagnosis/mortality/radionuclide imaging
Kaplan-Meier Estimate
Liver Neoplasms/diagnosis/mortality/radionuclide imaging
Middle Aged
Neoplasm Staging
Positron-Emission Tomography/standards
Proportional Hazards Models
Radiopharmaceuticals/diagnostic use/metabolism/standards
Retrospective Studies
Tomography, X-Ray Computed/standards
Fluorodeoxyglucose F18


  • Fig. 1. Univariate analysis of the patient population, tumor characteristics, and overall survival. Kaplan-Meier survival curves with log rank comparisons between each group of final diagnosis (A), morphological type (B), histologic grade (C), treatment method (D), American Joint Committee on Cancer stage (E) and primary tumor standardized uptake value (SUVmax) (F). Log rank p-values were <0.05 for each comparison, respectively.

  • Fig. 2. Axial FDG PET-CT images of two patients with common bile duct cancer who received nonsurgical treatment. Primary tumor maximum standardized uptake value is 3.1 (arrow) in 69-year-old man who was alive 26 months after diagnosis (A), and 9.9 (arrow) in 76-year-old man who died 10 months after diagnosis (B), respectively.



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