title: Detection of recurrent pancreatic cancer: comparison of FDG-PET with CT/MRI.
abstract: OBJECTIVE
  To determine the value of fluorine-18-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for the detection of recurrent pancreatic cancer in comparison to computed tomography (CT) and magnetic resonance imaging (MRI).
  
  
  METHODS
  Thirty-one patients with suspected recurrence after surgery were included. Inclusion criteria were sudden weight loss, pain or increased CA 19-9 levels. FDG-PET was performed in all patients. After visual analysis, maximal standardized uptake values (SUVmax) were determined by placing regions of interest on the pancreas bed. Additionally, all patients underwent contrast-enhanced multidetector CT (n = 14) or MR (n = 17) imaging. Positive findings at FDG-PET or CT/MRI were compared to follow-up.
  
  
  RESULTS
  All patients relapsed. Of 25 patients with local recurrences upon follow-up, initial imaging suggested relapse in 23 patients. Of these, FDG-PET detected 96% (22/23) and CT/MRI 39% (9/23). Local SUVmax ranged from 2.26 to 16.9 (mean, 6.06). Among 12 liver metastases, FDG-PET detected 42% (5/12). CT/MRI detected 92% (11/12) correctly. Moreover, 7/9 abdominal lesions were malignant upon follow-up of which FDG-PET detected 7/7 and CT/MR detected none. Additionally, FDG-PET detected extra-abdominal metastases in 2 patients.
  
  
  CONCLUSIONS
  In patients suspected of pancreatic cancer relapse; FDG-PET reliably detected local recurrences, whereas CT/MRI was more sensitive for the detection of hepatic metastases. Furthermore, FDG-PET proved to be advantageous for the detection of nonlocoregional and extra-abdominal recurrences.
authors.affiliation: Klinik fur Strahlenheilkunde und PET-Zentrum Berlin, Berlin, Germany. juri.ruf@charite.de
authors.forename: Juri
authors.initials: J
authors.lastname: Ruf
authors.forename: Enrique
authors.initials: E
authors.lastname: Lopez Hänninen
authors.forename: Helmut
authors.initials: H
authors.lastname: Oettle
authors.forename: Michail
authors.initials: M
authors.lastname: Plotkin
authors.forename: Uwe
authors.initials: U
authors.lastname: Pelzer
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: Roland
authors.initials: R
authors.lastname: Felix
authors.forename: Holger
authors.initials: H
authors.lastname: Amthauer
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18