Hybrid PET/CT scanners allow accurate anatomical localisation of metabolically active tumour sites, resulting in improvements in staging and treatment planning.

Cholangiocarcinoma (CCA) is a malignancy of bile ducts and gall-bladder which can be difficult to diagnose. Radical surgery for CCA is invasive, requires a long recovery and is not indicated if there is distant spread. PET/CT scans enable oncologists and surgeons to plan appropriate treatment for these patients, in particular where curative surgery in planned.

A retrospective review of Royal Adelaide Hospital PET/CT records 2005-2008 revealed 12 patients referred for suspected malignancies in the bile ducts or gall bladder. Five had been previously treated for CCA and suspected recurrence was confirmed on PET/CT scan. In a patient suspected of having colorectal cancer, PET/CT scanning was able to localise a metabolically active site in the bile duct, suggesting CCA as the likely primary. In another patient no metabolically active site in the region of the bile ducts or liver was seen, excluding CCA as the cause of symptoms.

The technique has proved useful in this small group of patients, and CCA should be added to the list of malignancies in which PET/CT scanning should be considered for initial diagnosis, staging and follow up.