The value of 18F-FDG PET/CT in pancreatic carcinoma

Objectives To clarify the value of ¹⁸F-FDG PET/CT in differential diagnosis of pancreatic lesions and detection of lymph nodes and/or distant metastases.

Methods The PET/CT scans for 46 consecutive patients (25 males, 21 famels; mean age 53.24±16.16 years) suspected with pancreatic masses were retrospectively analyzed. All patients had not received any treatments before PET/CT scan yet. Among them, 26 had pancreatic carcinoma, 20 had benign lesions (17chronic pancreatitis, 1 duodenal stromal tumor, 1 islet cell tumor, 1 congenital pancreatic variation). The sensitivity and specificity of PET/CT, PET alone and CT alone for pancreatic carcinoma were assessed and compared. The final results were confirmed by histopathologic examination or clinical follow up.

Results The sensitivity and specificity of PET/CT scan for pancreatic carcinoma were 88.5% and 90.0% with SUVmax 2.95, PET scan alone were 88.5and 85.0, there were no significant difference between PET/CT and PET alone. The sensitivity and specificity of CT scan alone were 76.9 and 65.0, there were significant difference between PET/CT scan and CT scan alone. ¹⁸F-FDG PET/CT scan had false positive results in 3 cases, false negative results in 2 cases. ¹⁸F-FDG PET/CT found metastases lesions in liver (n=2), lung(n=4), bone(n=3) or lymph nodes(n=12) which were not detected with CT imaging in 16 cases. According to the results of ¹⁸F-FDG PET/CT scan, the managements had been changed in 15 patients(up-staging, n=11; down-staging, n=4).

Conclusions ¹⁸F-FDG PET/CT is useful in differential diagnosis of pancreatic lesions and detecting lymph node and/or distant metastases in pancreatic carcinoma patients.

Research Support 1.Shanghai Leading Academic Discipline Project (project S30203), 2.Funds of Cooperation Research (project PY07002) 3.Education Commission of Shanghai Municipality Project (project 07ZZ34).