OBJECTIVE: We sought to determine the impact of positron emission tomography/computed tomography (PET/CT) on the management of presumed resectable pancreatic cancer and to assess the cost of this new staging procedure. SUMMARY BACKGROUND DATA: PET using 18F-fluorodeoxyglucose (FDG) is increasingly used for the staging of pancreatic cancer, but anatomic information is limited. Integrated PET/CT enables optimal anatomic delineation of PET findings and identification of FDG-negative lesions on computed tomography (CT) images and might improve preoperative staging. MATERIAL AND METHODS: Patients with suspected pancreatic cancer who had a PET/CT between June 2001 to April 2004 were entered into a prospective database. Routine staging included abdominal CT, chest x-ray, and CA 19-9 measurement. FDG-PET/CT was conducted according to a standardized protocol, and findings were confirmed by histology. Cost benefit analysis was performed based on charged cost of PET/CT and pancreatic resection and included the time frame of staging and surgery. RESULTS: Fifty-nine patients with a median age of 61 years (range, 40-80 years) were included in this analysis. Fifty-one patients had lesions in the head and 8 in the tail of the pancreas. The positive and negative predictive values for pancreatic cancer were 91% and 64%, respectively. PET/CT detected additional distant metastases in 5 and synchronous rectal cancer in 2 patients. PET/CT findings changed the management in 16% of patients with pancreatic cancer deemed resectable after routine staging (P = 0.031) and was cost saving. CONCLUSIONS: PET/CT represents an important staging procedure prior to pancreatic resection for cancer, since it significantly improves patient selection and is cost-effective.
OBJECTIVE: We sought to determine the impact of positron emission tomography/computed tomography (PET/CT) on the management of presumed resectable pancreatic cancer and to assess the cost of this new staging procedure. SUMMARY BACKGROUND DATA: PET using 18F-fluorodeoxyglucose (FDG) is increasingly used for the staging of pancreatic cancer, but anatomic information is limited. Integrated PET/CT enables optimal anatomic delineation of PET findings and identification of FDG-negative lesions on computed tomography (CT) images and might improve preoperative staging. MATERIAL AND METHODS:Patients with suspected pancreatic cancer who had a PET/CT between June 2001 to April 2004 were entered into a prospective database. Routine staging included abdominal CT, chest x-ray, and CA 19-9 measurement. FDG-PET/CT was conducted according to a standardized protocol, and findings were confirmed by histology. Cost benefit analysis was performed based on charged cost of PET/CT and pancreatic resection and included the time frame of staging and surgery. RESULTS: Fifty-nine patients with a median age of 61 years (range, 40-80 years) were included in this analysis. Fifty-one patients had lesions in the head and 8 in the tail of the pancreas. The positive and negative predictive values for pancreatic cancer were 91% and 64%, respectively. PET/CT detected additional distant metastases in 5 and synchronous rectal cancer in 2 patients. PET/CT findings changed the management in 16% of patients with pancreatic cancer deemed resectable after routine staging (P = 0.031) and was cost saving. CONCLUSIONS: PET/CT represents an important staging procedure prior to pancreatic resection for cancer, since it significantly improves patient selection and is cost-effective.
Authors: Gerhard W Goerres; Cyrill Burger; Ehab Kamel; Burkhardt Seifert; Achim H Kaim; Alfred Buck; Tobias C Buehler; Gustav K Von Schulthess Journal: Radiology Date: 2003-03 Impact factor: 11.105
Authors: Allessio Annovazzi; Marc Peeters; Annelies Maenhout; Alberto Signore; Rudi Dierckx; Christophe Van De Wiele Journal: Gastroenterology Date: 2003-10 Impact factor: 22.682
Authors: Axel Richter; Marco Niedergethmann; Jörg W Sturm; Dietmar Lorenz; Stefan Post; Michael Trede Journal: World J Surg Date: 2003-02-27 Impact factor: 3.352
Authors: Markus Selzner; Thomas F Hany; Peer Wildbrett; Lucas McCormack; Zakiyah Kadry; Pierre-Alain Clavien Journal: Ann Surg Date: 2004-12 Impact factor: 12.969
Authors: Chandrajit P Raut; Ana M Grau; Gregg A Staerkel; Madhukar Kaw; Eric P Tamm; Robert A Wolff; Jean-Nicolas Vauthey; Jeffrey E Lee; Peter W T Pisters; Douglas B Evans Journal: J Gastrointest Surg Date: 2003-01 Impact factor: 3.452
Authors: Darius C Desai; Emanuel E Zervos; Mark W Arnold; William E Burak; Joseph Mantil; Edward W Martin Journal: Ann Surg Oncol Date: 2003 Jan-Feb Impact factor: 5.344
Authors: Didier Lardinois; Walter Weder; Thomas F Hany; Ehab M Kamel; Stephan Korom; Burkhardt Seifert; Gustav K von Schulthess; Hans C Steinert Journal: N Engl J Med Date: 2003-06-19 Impact factor: 91.245
Authors: John P Neoptolemos; Deborah D Stocken; Helmut Friess; Claudio Bassi; Janet A Dunn; Helen Hickey; Hans Beger; Laureano Fernandez-Cruz; Christos Dervenis; François Lacaine; Massimo Falconi; Paolo Pederzoli; Akos Pap; David Spooner; David J Kerr; Markus W Büchler Journal: N Engl J Med Date: 2004-03-18 Impact factor: 91.245
Authors: K Herrmann; M Erkan; M Dobritz; T Schuster; J T Siveke; A J Beer; H J Wester; R M Schmid; H Friess; M Schwaiger; J Kleeff; A K Buck Journal: Eur J Nucl Med Mol Imaging Date: 2012-01-26 Impact factor: 9.236
Authors: Sam G Pappas; Kathleen K Christians; Parag P Tolat; Alan P Mautz; Alysandra Lal; Lisa McElroy; T Clark Gamblin; Kiran K Turaga; Susan Tsai; Beth Erickson; Paul Ritch; Douglas B Evans Journal: HPB (Oxford) Date: 2013-03-15 Impact factor: 3.647