American Journal of Roentgenology, Vol 171, 1565-1570, Copyright © 1998 by American Roentgen Ray Society

ARTICLES

Diagnosis of pancreatic carcinoma: role of FDG PET

MT Keogan, D Tyler, L Clark, MS Branch, VG McDermott, DM DeLong and RE Coleman
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.

OBJECTIVE: The purpose of this study was to investigate the role of positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) in differentiating benign from malignant disease in patients with possible pancreatic malignancy. SUBJECTS AND METHODS: All patients with a possible diagnosis of pancreatic carcinoma based on CT or ERCP findings were eligible for inclusion in this prospective study. PET imaging of the abdomen was performed in 37 patients and was interpreted as positive if FDG activity in the pancreas exceeded background activity and as negative if activity was less than or equal to background activity. Semiquantitative analysis was performed by calculating a standardized uptake ratio. Studies were reviewed independently by two radiologists, and results were correlated with biopsy results and with CT and ERCP findings. Sensitivity and specificity of FDG PET for revealing pancreatic malignancy was determined. RESULTS: FDG activity in the pancreas was increased in 24 patients, and adenocarcinoma was diagnosed in 22 of these patients (92%). Two patients (8%) with increased activity had benign disease, including one patient with chronic pancreatitis who showed no evidence of tumor at laparotomy and one patient with a mucinous cystic tumor who showed no malignant features at laparotomy. FDG uptake was low or normal in 13 patients, 10 of whom (77%) had benign disease. FDG uptake was also low in three patients with adenocarcinoma, whose tumor size ranged from 2 to 4 cm in diameter. The mean standardized uptake ratio value for malignant disease was 5.1 (range, 1.0-10.1) and for benign disease was 1.9 (range, 0.0-5.8) (p < .001). The sensitivity of FDG PET for revealing malignant disease in the pancreas was 88% and the specificity was 83%. CONCLUSION: FDG PET is a sensitive and specific noninvasive technique for the diagnosis of pancreatic malignancy.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. M. Farma, A. A. Santillan, M. Melis, J. Walters, D. Belinc, D.-T. Chen, E. A. Eikman, and M. Malafa PET/CT Fusion Scan Enhances CT Staging in Patients with Pancreatic Neoplasms Ann. Surg. Oncol., September 1, 2008; 15(9): 2465 - 2471. [Abstract] [Full Text] [PDF]

				D. J. A. Margolis, J. M. Hoffman, R. J. Herfkens, R. B. Jeffrey, A. Quon, and S. S. Gambhir Molecular Imaging Techniques in Body Imaging Radiology, November 1, 2007; 245(2): 333 - 356. [Abstract] [Full Text] [PDF]

				E. M. Rohren, T. G. Turkington, and R. E. Coleman Clinical Applications of PET in Oncology Radiology, May 1, 2004; 231(2): 305 - 332. [Abstract] [Full Text] [PDF]

				M. K. Kalra, M. M. Maher, G. W. Boland, S. Saini, and A. J. Fischman Correlation of Positron Emission Tomography and CT in Evaluating Pancreatic Tumors: Technical and Clinical Implications Am. J. Roentgenol., August 1, 2003; 181(2): 387 - 393. [Full Text] [PDF]

				B B Chin and R L Wahl 18F-Fluoro-2-deoxyglucose positron emission tomography in the evaluation of gastrointestinal malignancies Gut, June 1, 2003; 52(90004): iv23 - 29. [Abstract] [Full Text] [PDF]

				M. F. Kalady, B. M. Clary, L. A. Clark, M. Gottfried, E. M. Rohren, R. E. Coleman, T. N. Pappas, and D. S. Tyler Clinical Utility of Positron Emission Tomography in the Diagnosis and Management of Periampullary Neoplasms Ann. Surg. Oncol., October 1, 2002; 9(8): 799 - 806. [Abstract] [Full Text] [PDF]

				A. C. Buck, H. H. Schirrmeister, C.-A. Guhlmann, C. G. Diederichs, C. Shen, I. Buchmann, J. Kotzerke, D. Birk, T. Mattfeldt, and S. N. Reske Ki-67 Immunostaining in Pancreatic Cancer and Chronic Active Pancreatitis: Does In Vivo FDG Uptake Correlate with Proliferative Activity? J. Nucl. Med., May 1, 2001; 42(5): 721 - 725. [Abstract] [Full Text]

				E EFTHIMIOU, T CRNOGORAC-JURCEVIC, N R LEMOINE, and T A BRENTNALL Inherited predisposition to pancreatic cancer Gut, February 1, 2001; 48(2): 143 - 147. [Full Text] [PDF]

				R. R. Raylman Performance of a Dual, Solid-State Intraoperative Probe System with 18F, 99mTc, and 111In J. Nucl. Med., February 1, 2001; 42(2): 352 - 360. [Abstract] [Full Text]