PT - JOURNAL ARTICLE AU - Saila Kauhanen AU - Irina Rinta-Kiikka AU - Jukka Kemppainen AU - Juha Grönroos AU - Sami Kajander AU - Marko Seppänen AU - Kalle Alanen AU - Risto Gullichsen AU - Pirjo Nuutila AU - Jari Ovaska TI - Accuracy of <sup>18</sup>F-FDG PET/CT, Multidetector CT, and MR Imaging in the Diagnosis of Pancreatic Cysts: A Prospective Single-Center Study AID - 10.2967/jnumed.114.148940 DP - 2015 Aug 01 TA - Journal of Nuclear Medicine PG - 1163--1168 VI - 56 IP - 8 4099 - http://jnm.snmjournals.org/content/56/8/1163.short 4100 - http://jnm.snmjournals.org/content/56/8/1163.full SO - J Nucl Med2015 Aug 01; 56 AB - Accurate diagnosis of the nature of pancreatic cysts is challenging but more important than ever, in part because of the increasing number of incidental cystic findings in the pancreas. Preliminary data suggest that 18F-FDG PET/CT may have a significant influence on clinical decision making, although its role is still evolving. Our aim was to prospectively compare the accuracy of combined 18F-FDG PET and contrast-enhanced CT (18F-FDG PET/CT), multidetector CT (MDCT), and MR imaging in differentiating malignant from benign pancreatic cysts. Methods: Thirty-one consecutive patients with pancreatic cysts were enrolled in the study. They underwent a protocol including 18F-FDG PET/CT, MDCT, and MR imaging combined with MR cholangiopancreatography, all of which were evaluated in a masked manner. The findings were confirmed macroscopically at surgery or histopathologic analysis (n = 22) or at follow-up (n = 9). Results: Of the 31 patients, 6 had malignant and 25 had benign lesions. The diagnostic accuracy was 94% for 18F-FDG PET/CT, compared with 77% and 87% for MDCT (P &lt; 0.05) and MR imaging, respectively. 18F-FDG PET/CT had a negative predictive value of 100% and a positive predictive value of 75% for pancreatic cysts. The maximum standardized uptake value was significantly higher in malignant (7.4 ± 2.6) than in benign lesions (2.4 ± 0.8) (P &lt; 0.05). When the maximum standardized uptake value was set at 3.6, the sensitivity and specificity were 100% and 88%, respectively. Furthermore, when compared with MDCT and MR imaging, respectively, 18F-FDG PET/CT altered the clinical management of 5 and 3 patients, respectively. Conclusion: 18F-FDG PET/CT is an accurate imaging modality for differentiating between benign and malignant pancreatic cysts. We recommend the use of 18F-FDG PET/CT in the evaluation of diagnostically challenging pancreatic cysts.