FDG-PET is able to detect pancreatic carcinoma in chronic pancreatitis.
OBJECTIVE
2-(18F)-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) is an imaging technique which enables detection of malignancies. FDG-PET has been established as a tool for the diagnosis of pancreatic carcinoma (CA). Early detection is mandatory as cure can only be achieved in non-advanced disease. This is, however, very difficult with conventional radiological techniques. Patients with chronic pancreatitis (CP) are at risk of developing CA. A simple, reliable screening method for malignant degeneration is highly desirable. We set out to investigate whether FDG-PET is able to detect CA in the setting of CP and can fulfil a potential role in the early detection of CA in CP.


METHODS
FDG-PET was performed in 77 CP patients and in six patients with CP complicated by CA (CP + CA). We included 26 CA patients as a positive control. A positive scan was defined as focal FDG accumulation in the pancreas region.


RESULTS
In 67 of the 77 CP (87%) patients, pancreatic FDG accumulation was absent. Six patients had significant accumulation. In CA, 24/26 patients had a positive PET. Five out of the six patients with CP + CA had focal uptake, while minor uptake was seen in one patient. FDG-PET was positive in almost all CA patients and CP + CA patients. FDG-PET was negative in the large majority (87%) of CP patients, which suggests that a positive PET scan in CP patients must lead to efforts to exclude a malignancy.


CONCLUSIONS
These data suggest that FDG-PET has a potential role as a diagnostic tool for detecting CA in longstanding CP.
van Kouwen
Mariëtte C A
MC
Department of Gastroenterology, University Medical Center, St. Radboud, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. m.vankouwen@mdl.umcn.nl
Jansen
Jan B M J
JB
van Goor
Harry
H
de Castro
Steve
S
Oyen
Wim J G
WJ
Drenth
Joost P H
JP
D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000209:etiology; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging*; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18