Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Clinical Usefulness of $^{18}F2$-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Scan in the Diagnosis of Ampullary Carcinoma

바터팽대부암종(Ampullary Carcinoma)의 진단에 있어서 $^{18}F2$-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Scan의 유용성

  • Nam, Se-Jin (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Chung, Jae-Joon (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Dae-Jung (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Cho, Eun-Suk (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Ahn, Jhii-Hyun (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Joo-Hee (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Yu, Jeong-Sik (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 남세진 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 정재준 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 김대중 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 조은석 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 안지현 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 김주희 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 유정식 (연세대학교 의과대학 강남세브란스병원 영상의학과)
  • Published : 2011.08.01
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Abstract

Purpose: To evaluate the clinical usefulness of the $^{18}F$ 2-fluoro-2-deoxy-D-glucose positron emission tomography ($^{18}F$-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 ${\pm}$ 3.1. Most (94.9%) of all patients showed high FDG uptake over 2.5 with 93.9% in Group B and C. Conclusion: $^{18}F$-FDG PET scan was use for the detection of ampulla of Vater cancer, even though the lesion was invisible on CT.

목적: 바터팽대부암종의 진단에 있어서 $^{18}F$ 2-fluoro-2-deoxy-D-glucose positron emission tomography ($^{18}F$-FDG PET) 영상의 임상적 유용성에 대하여 알아보고자 하였다. 대상과 방법: 바터팽대부암종으로 진단된 39명의 환자를 대상으로 CT에서 병변의 크기, 위치, 담췌관의 확장 등을 평가하였다. 병변이 잘 보이는지 여부에 따라 3 그룹(그룹 A: 종괴가 관찰되는 경우, 그룹 B: 종괴는 보이지 않으나 팽대부가 현저하여 병변이 의심되는 경우, 그룹 C: 병변이 보이지 않는 경우)으로 분류하였다. PET 영상은 standardized up-take value (SUV)를 측정하여 CT의 병변 발견율과 비교하였다. 결과: 24명(61.5%)의 환자가 그룹 A, 11명(28.2%)이 그룹 B, 4명(10.3%)이 그룹 C로 분류되었다. 그룹 A환자 모두(100%), 그룹 B환자 10명(90.9%), 그룹 C환자 3명(75.0%)에서 담관 확장이 보였고, 그룹 A에서 18명(75.0%), 그룹 B에서 9명(81.8%), 그룹 C에서 1명(25.0%)에서 췌관 확장이 보였다. 전체 39명의 SUV값은 평균 5.90 ${\pm}$ 3.1이었고, 2명을 제외한 37명(94.9%)에서 SUV 2.5 이상의 높은 FDG 섭취를 보였다. 특히 그룹 B와 C의 15명의 환자 중 14명(93.3%)의 환자에서 2.5 이상의 SUV를 보였다. 결론: $^{18}F$-FDG PET는 바터팽대부암종의 진단에 있어서 높은 병변의 발견율을 보였고, 특히 CT에서 병변이 보이지 않는 경우에도 바터팽대부암종을 의심하는 데 도움이 되었다.

Keywords

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