Utility of 18F-FDG PET/CT for differentiation of autoimmune pancreatitis with atypical pancreatic imaging findings from pancreatic cancer.
OBJECTIVE
This study was conducted to evaluate the clinical usefulness of PET/CT in differentiating autoimmune pancreatitis from pancreatic cancer.


METHODS
To differentiate autoimmune pancreatitis from pancreatic cancer, we analyzed the cases of 17 patients with autoimmune pancreatitis and atypical pancreatic imaging findings who underwent integrated PET/CT. The PET/CT findings on the 17 patients with autoimmune pancreatitis were compared with those of 151 patients with pancreatic cancer.


RESULTS
Fluorine-18 FDG uptake by the pancreas was found in all patients with autoimmune pancreatitis and in 82% (124/151) of patients with pancreatic cancer. Diffuse uptake by the pancreas was significantly more frequent in patients with autoimmune pancreatitis (53% vs 3%, p < 0.001). FDG uptake by the salivary glands and kidneys was seen only in patients with autoimmune pancreatitis, the former reaching statistical significance (p = 0.003). Follow-up PET/CT after steroid therapy was performed for eight patients with autoimmune pancreatitis. After steroid therapy, none of the patients had intense FDG uptake by the pancreas or extrapancreatic organs.


CONCLUSIONS
In difficult cases, at PET/CT the presence of diffuse uptake of FDG by the pancreas or concomitant extrapancreatic uptake by the salivary glands can be used to aid in differentiation of autoimmune pancreatitis and pancreatic cancer.
Lee
Tae Yoon
TY
Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Kim
Myung-Hwan
MH
Park
Do Hyun
DH
Seo
Dong Wan
DW
Lee
Sung Koo
SK
Kim
Jae Seung
JS
Lee
Kyu Taek
KT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007668:Kidney / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D010195:Pancreatitis / Q000175:diagnosis* / Q000378:metabolism; D049268:Positron-Emission Tomography / Q000379:methods*; D012469:Salivary Glands / Q000378:metabolism; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
D019788:Fluorodeoxyglucose F18