title: Value of contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography in detection and presurgical assessment of pancreatic cancer: a prospective study.
abstract: OBJECTIVE
  Positron Emission Tomography (PET) using (18)F-fluorodeoxyglucose (FDG) associated with computed tomography (CT) is increasingly used for the detection and the staging of pancreatic cancer, but data regarding its clinical added value in pre-surgical planning is still lacking. The aim of this study is to investigate the performance of FDG PET associated with contrast-enhanced CT in detection of pancreatic cancer.
  
  
  METHODS
  We prospectively evaluated FDG PET/CT studies obtained in patients with suspicion of operable pancreatic cancer between May 2006 and January 2008. Staging was conducted according to a standardized protocol, and findings were confirmed in all patients by surgical resection or biopsy examination.
  
  
  RESULTS
  Forty-five patients with a median age of 69 (range 22-82) were included in this study. Thirty-six had malignant tumors and nine had benign lesions (20%). The sensitivity of enhanced versus unenhanced PET/CT in the detection of pancreatic cancer was 96% versus 72% (P=0.076), the specificity 66.6% versus 33.3% (P=0.52), the positive predictive value 92.3% versus 80% (P=0.3), the negative predictive value 80% versus 25% (P=0.2), and the accuracy 90.3% versus 64% (P=0.085).
  
  
  CONCLUSIONS
  Our preliminary data obtained in a limited number of patients shows that contrast-enhanced FDG PET/CT offers good sensitivity in the detection and assessment of pancreatic cancer, but at the price of a relatively low specificity. Enhanced PET/CT seems to be superior to unenhanced PET/CT. Further larger prospective studies are needed to establish its value for pre-surgical diagnosis and staging in pancreatic cancer.
authors.affiliation: Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospitals of Geneva, Switzerland. nicolas.c.buchs@hcuge.ch
authors.forename: Nicolas C
authors.initials: NC
authors.lastname: Buchs
authors.forename: Leo
authors.initials: L
authors.lastname: Bühler
authors.forename: Pascal
authors.initials: P
authors.lastname: Bucher
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Willi
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Frossard
authors.forename: Arnaud D
authors.initials: AD
authors.lastname: Roth
authors.forename: Pietro
authors.initials: P
authors.lastname: Addeo
authors.forename: Antoine
authors.initials: A
authors.lastname: Rosset
authors.forename: Sylvain
authors.initials: S
authors.lastname: Terraz
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Becker
authors.forename: Osman
authors.initials: O
authors.lastname: Ratib
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016009:Chi-Square Distribution; D003287:Contrast Media; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013557:Switzerland; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18