18F-FDG Positron Emission Tomography CT (FDG
PET-CT) in the Management of Pancreatic Cancer: Initial Experience
in 12 Patients
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Muhammad Wasif Saif1, Daniel Cornfeld1,
Houmayoun Modarresifar2, Buddhiwardhan Ojha2
1) Yale University School of Medicine, New Haven, CT;
2) University of Alabama at Birmingham, Birmingham, AL, USA.
Introduction. Staging and restaging of pancreatic
malignancy can be demanding. Often, there are liver lesions seen
on diagnostic CT suspicious for secondary deposits. Positron emission
tomography (PET)-CT may have a great potential in confirming or
ruling out actual malignancy in those areas. Methods We prospectively
studied 12 pancreatic adenocarcinoma patients, who had undergone
PET-CT imaging as part of their staging or restaging process.
Imaging was performed after intravenous administration of 10 mCi
F-18 FDG. Results were compared with CT, histopathological findings
and/or clinical follow up.
Results. PET-CT correctly identified 11 lesions
and ruled the absence of disease in 4 out of 4 patients (PPV 92%,
NPV of 100%, and accuracy 94%), compared to CT which had (PPV
79%, NPV 50% and accuracy 75%). CT identified 4 metastatic liver
lesions in 12 patients of which 3 were actually benign processes.
Conclusion. FDG-PET detects pancreatic malignancy and metastatic
disease with higher accuracy than conventional CT. The ability
of PET-CT to rule out or correctly identify metastases greatly
enhances the physician's decision-making process to choose the
right therapeutic intervention.
PET scan - pancreatic cancer - CT scan - PET-CT scan - liver metastases