18F-FDG Positron Emission Tomography CT (FDG PET-CT) in the Management of Pancreatic Cancer: Initial Experience in 12 Patients

download Full Article (PDF file)

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.

Abstract

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.

Key words
PET scan - pancreatic cancer - CT scan - PET-CT scan - liver metastases