Diagnosis of pancreatic carcinoma

Role of FDG PET

Mary T. Keogan, Douglas Tyler, Lisa Clark, M. Stanley Branch, Vincent G. McDermott, David M. DeLong, R. Edward Coleman

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1565-1570
Number of pages6
JournalAmerican Journal of Roentgenology
Volume171
Issue number6
StatePublished - Dec 1998
Externally publishedYes

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Positron-Emission Tomography
Pancreas
Neoplasms
Endoscopic Retrograde Cholangiopancreatography
Laparotomy
Adenocarcinoma
Pancreatic Carcinoma
Fluorodeoxyglucose F18
Chronic Pancreatitis
Abdomen
Prospective Studies
Biopsy
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Keogan, M. T., Tyler, D., Clark, L., Branch, M. S., McDermott, V. G., DeLong, D. M., & Coleman, R. E. (1998). Diagnosis of pancreatic carcinoma: Role of FDG PET. American Journal of Roentgenology, 171(6), 1565-1570.

Diagnosis of pancreatic carcinoma : Role of FDG PET. / Keogan, Mary T.; Tyler, Douglas; Clark, Lisa; Branch, M. Stanley; McDermott, Vincent G.; DeLong, David M.; Coleman, R. Edward.

In: American Journal of Roentgenology, Vol. 171, No. 6, 12.1998, p. 1565-1570.

Research output: Contribution to journalArticle

Keogan, MT, Tyler, D, Clark, L, Branch, MS, McDermott, VG, DeLong, DM & Coleman, RE 1998, 'Diagnosis of pancreatic carcinoma: Role of FDG PET', American Journal of Roentgenology, vol. 171, no. 6, pp. 1565-1570.
Keogan MT, Tyler D, Clark L, Branch MS, McDermott VG, DeLong DM et al. Diagnosis of pancreatic carcinoma: Role of FDG PET. American Journal of Roentgenology. 1998 Dec;171(6):1565-1570.
Keogan, Mary T. ; Tyler, Douglas ; Clark, Lisa ; Branch, M. Stanley ; McDermott, Vincent G. ; DeLong, David M. ; Coleman, R. Edward. / Diagnosis of pancreatic carcinoma : Role of FDG PET. In: American Journal of Roentgenology. 1998 ; Vol. 171, No. 6. pp. 1565-1570.
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abstract = "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.",
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N2 - 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.

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