BACKGROUND: This study examined the effect that 18-fluorodeoxyglucose positron emission tomography ((18)FDG-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 (18)FDG-PET and abdominal computed tomography (CT). Malignant or benign disease was confirmed pathologically in 47 patients. RESULTS: Of the 41 patients with malignancy, (18)FDG-PET failed to identify the primary tumor in 5 patients. (18)FDG-PET demonstrated increased uptake suggesting primary malignancy in 37 patients. Malignant pathology was confirmed in 36 cases. (18)FDG-PET identified malignant locoregional lymph node metastases in six of ten patients. All nodes identified before surgery by (18)FDG-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. (18)FDG-PET did not detect metastasis in any of these cases. Before surgery, (18)FDG-PET identified distant metastases that were not detected by CT in one patient. CONCLUSIONS: Despite high sensitivity and specificity in diagnosing periampullary malignancy, (18)FDG-PET did not change clinical management in the vast majority of patients previously evaluated by CT. In addition, (18)FDG-PET missed >10% of periampullary malignancies and did not provide the anatomical detail necessary to define unresectabilty.
BACKGROUND: This study examined the effect that 18-fluorodeoxyglucose positron emission tomography ((18)FDG-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 (18)FDG-PET and abdominal computed tomography (CT). Malignant or benign disease was confirmed pathologically in 47 patients. RESULTS: Of the 41 patients with malignancy, (18)FDG-PET failed to identify the primary tumor in 5 patients. (18)FDG-PET demonstrated increased uptake suggesting primary malignancy in 37 patients. Malignant pathology was confirmed in 36 cases. (18)FDG-PET identified malignant locoregional lymph node metastases in six of ten patients. All nodes identified before surgery by (18)FDG-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. (18)FDG-PET did not detect metastasis in any of these cases. Before surgery, (18)FDG-PET identified distant metastases that were not detected by CT in one patient. CONCLUSIONS: Despite high sensitivity and specificity in diagnosing periampullary malignancy, (18)FDG-PET did not change clinical management in the vast majority of patients previously evaluated by CT. In addition, (18)FDG-PET missed >10% of periampullary malignancies and did not provide the anatomical detail necessary to define unresectabilty.
Authors: Hee Seung Lee; Jong Soon Jang; Seungho Lee; Myeong Ho Yeon; Ki Bae Kim; Jae Geun Park; Joo Young Lee; Mi Jin Kim; Joung-Ho Han; Rohyun Sung; Seon Mee Park Journal: Clin Endosc Date: 2015-05-29
Authors: Kathryn J Schunke; Lauren M Rosati; Marianna Zahurak; Joseph M Herman; Amol K Narang; Irina Usach; Alison P Klein; Charles J Yeo; Larry T Korman; Ralph H Hruban; John L Cameron; Daniel A Laheru; Ross A Abrams Journal: Adv Radiat Oncol Date: 2017-08-03