Clinical utility of positron emission tomography in the diagnosis and management of periampullary neoplasms

Matthew F. Kalady, Bryan M. Clary, Lisa A. Clark, Marcia Gottfried, Eric M. Rohren, R. Edward Coleman, Theodore N. Pappas, Douglas S. Tyler

Research output: Contribution to journalArticle

55 Scopus citations

Abstract

Background: This study examined the effect that 18-fluorodeoxyglucose positron emission tomography (18FDG-PET) imaging had on the clinical management of patients with suspected periampullary malignancy. Methods: Fifty-four patients with suspected pancreatic neoplasms underwent both whole-body 18FDG-PET and abdominal computed tomography (CT). Malignant or benign disease was confirmed pathologically in 47 patients. Results: Of the 41 patients with malignancy, 18FDG-PET failed to identify the primary tumor in 5 patients. 18FDG-PET demonstrated increased uptake suggesting primary malignancy in 37 patients. Malignant pathology was confirmed in 36 cases. 18FDG-PET identified malignant locoregional lymph node metastases in six of ten patients. All nodes identified before surgery by 18FDG-PET were also seen on preoperative CT. Six patients who were thought to have resectable disease by CT were found to have distant metastasis at laparotomy. 18FDG-PET did not detect metastasis in any of these cases. Before surgery, 18FDG-PET identified distant metastases that were not detected by CT in one patient. Conclusions: Despite high sensitivity and specificity in diagnosing periampullary malignancy, 18FDG-PET did not change clinical management in the vast majority of patients previously evaluated by CT. In addition, 18FDG-PET missed > 10% of periampullary malignancies and did not provide the anatomical detail necessary to define unresectabilty.

Original languageEnglish (US)
Pages (from-to)799-806
Number of pages8
JournalAnnals of surgical oncology
Volume9
Issue number8
DOIs
StatePublished - Oct 1 2002
Externally publishedYes

Keywords

  • Computed tomography
  • Diagnostic imaging
  • Pancreatic cancer
  • Periampullary cancer
  • Positron emission tomography

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Kalady, M. F., Clary, B. M., Clark, L. A., Gottfried, M., Rohren, E. M., Edward Coleman, R., Pappas, T. N., & Tyler, D. S. (2002). Clinical utility of positron emission tomography in the diagnosis and management of periampullary neoplasms. Annals of surgical oncology, 9(8), 799-806. https://doi.org/10.1245/ASO.2002.03.072