Table 2.
Cross-sectional imaging, PET/MRI characteristics and follow-up
| Patient # | CT | MRI/MRCP | PET/MRI | Stent in situ | SUVmax | TLR | TBR | Diagnostic value | Effect on CDM | Final Diagnosis | Surgery | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TNMa | BC | TNMa | BC | TNM | BC | TNM | ||||||||
| 1 | T2aN2M0 | 3a | T2aN2M0 | 3a | T2aN1M0 | 3 A | - | 3.7 | 1.09 | 2.18 | PET MRI made lymph nodes suspicious for metastases | - a | pCCA, clinical follow-up | X |
| 2 | T2bN1M0 | 3b | T2bN1M0 | 3b | T2bN0M0 | 3B | - | 1.8 | 0.9 | 1.06 | No additional information | - |
pCCA, resection (path-proven) |
T3N0Mx |
| 3 | T2bN2M0 | 2 | T2bN2M0 | 2 | T2bN0M0 | 2 | - | 5.6 | 2.15 | 2.95 | No additional information | - |
pCCA, biopsy (path-proven) |
X |
| 4 | T3N1M0 | 3a | T3N1M0 | 3a | T2bN1M0 | 3 A | PS + PTCD | 4.2 | 1.75 | 2.21 | No additional information | - |
Unresectable pCCA, DLS (path-proven) |
T4N1Mx |
| 5 | T2aN1M0 | 1 | T2aN1M0 | 1 | T2aN1M0 | 1 | - | 6.2 | 2.58 | 4.77 | Increase suspicion of malignancy compared to previous imaging | + |
Unresectable pCCA, DLS (path-proven) |
TxN2Mx |
| 6 | T2aN1M0 | 3b | T2aN1M0 | 3b | T2aN1M0 | 3B | - | 6.3 | 1.91 | 2.74 | No additional information | - |
Intraductal high grade dysplasia, resection (path-proven) |
Tx/1N0Mxb |
| 7 | T2aN1M0 | 3a | T2aN1M0 | 3a | T2aN0M0 | 3 A | PS + 2 ucSEMS | 2.9 | 1.26 | 1.71 | No additional information | - |
pCCA, resection (path-proven) |
T2aN0Mx |
| 8 | T2bN1M0 | 1 | T2bN1M0 | 1 | X | X | PS + fcSEMS | 5.5 | 2.2 | 3.06 | PET avidity around the plastic stent most likely due to reactive or inflammatory changes | - |
Benign pathology, resection (path-proven) |
X |
| 9 | T3N1Mx | 2 | T3N1Mx | 2 | T2bN0Mx | 3 A | 2x PS | 5.3 | 2.3 | 4.08 | Enlarged regional LN possible malignant on CT and MRI, not PET avid and not suspicious with PET | - c |
pCCA, resection with LN negative (path-proven) |
T2aN0Mx |
| 10 | T2aN1M0 | 2 | T2aN1M0 | 2 | T2aN0M0 | 2 | PS | 6.9 | 3.45 | 3.14 | No additional information | - |
pCCA, biopsy (path-proven) |
TxN1Mx |
| 11 | T1N0M0 | 1 | T1N0M0 | 1 | T1N0M0 | 1 | - | 3.1 | 1.41 | 2.07 | Increase suspicion of malignancy compared to previous imaging | + |
pCCA, resection (path-proven) |
T1N1Mx |
| 12 | X | X | X | X | X | X | - | 5 | 2.5 | 3.33 | No additional information | - |
Follicular lymphoma, resection (path-proven) |
X |
| 13 | T4N1M0 | 4 | T4N1M0 | 4 | T4N0M0 | 4 | - | 5.1 | 1.59 | 2.68 | Enlarged regional LN possible malignant on CT and MRI, not PET avid and not suspicious with PET | - |
pCCA, brush (path-proven) |
TxN1Mx |
| 14 | X | X | X | X | X | X | - | 2.7 | 1.08 | 1.59 | No additional information | - | IgG4 mediated disease, prednisone treatment with good effect. FU for 9 months | X |
IgG4 = Immunoglobulin G 4, SUV = Standardized Uptake Value, TLR = Tumour to Liver Ratio, TBR = Tumour to Blood pool Ratio, DLS = diagnostic laparoscopy, LN = lymph nodes, path-proven = histopathology proven disease, PS = plastic stent, PTCD = percutaneous trans-hepatic catheter drainage, ucSEMS = uncovered self-expanding metal stent, fcSEMS = fully covered self-expanding metal stent, BC = Bismuth-Corlette, CDM = Clinical Decision Making, TNM = Tumour, Node, Metastasis
a Palliative treatment per request of the patient
b IPNB without infiltrative growth
c Regardless of suspicious lymph nodes surgery, therefore no impact on clinical decision making