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[ 18 F]FDG accumulation in an experimental model of multistage progression of cholangiocarcinoma
Author(s) -
Laverman Peter,
Blokx Willeke A.M.,
Te Morsche René H.M.,
Frielink Cathelijne,
Boerman Otto C.,
Oyen Wim J.G.,
Drenth Joost P.H.
Publication year - 2007
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/j.1872-034x.2007.00016.x
Subject(s) - thioacetamide , cirrhosis , positron emission tomography , medicine , stage (stratigraphy) , pathological , pathology , carcinoma , hepatocellular carcinoma , nuclear medicine , gastroenterology , chemistry , biology , paleontology
Aim: The diagnosis of cholangiocarcinoma (CCA) is difficult, and due to the insidious course of the disease, most cases present at a relatively late stage. Positron emission tomography (PET), using [ 18 F]fluoro‐2‐deoxyglucose ([ 18 F]FDG) as a tracer is one the most powerful molecular imaging techniques available. We hypothesized that [ 18 F]FDG accumulates at sites of early CCA development and that FDG‐PET may be of value for the early diagnosis of CCA. Methods: We added 300 mg/L thioacetamide to the drinking water of rats who went on to develop CCA within 20 weeks. From eight weeks onwards, groups of three rats were injected with [ 18 F]FDG, subsequently the liver was perfused, dissected and subjected to quantitative autoradiography using a phosphor imaging system. The liver sections were stained for histology, and glutathione S‐transferase (GST) enzyme activity was determined. We correlated [ 18 F]FDG uptake with pathological liver changes. Results: The experiments demonstrate that thioacetamide causes atypical bile ducts and invasive CCA. Rat livers harvested early after the start of administration of thioacetamide contained only cirrhosis and/or atypical bile ducts, but CCA and FDG accumulation were absent. At 20 weeks, all rats had developed CCA and all, except two animals with a very small carcinoma, had strongly elevated focal FDG uptake. Quantitative autoradiography revealed tumor‐to‐normal‐liver ratios as high as 5:4. In all rats with a carcinoma, there was a backdrop of cirrhosis, and interestingly cirrhotic areas did not show elevated FDG accumulation. Conclusion: [ 18 F]FDG accumulates in CCA, is able to distinguish CCA from liver cirrhosis, but is probably unsuitable to detect very early CCA lesions.