18F-fluorodeoxyglucose positron emission tomography in the diagnosis of small pancreatic cancer.
OBJECTIVE
To investigate the role of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the diagnosis of small pancreatic cancer.


METHODS
This study involved 31 patients with proven invasive ductal cancer of the pancreas. The patients were divided into 3 groups according to the maximum diameter of the tumor: TS1 (maximum tumor size ≤ 2.0 cm), TS2 (> 2.0 cm and ≤ 4.0 cm) or TS3-4 (> 4.0 cm). The relationships between the TS and various diagnostic tools, including FDG-PET with dual time point evaluation, were analyzed.


RESULTS
The tumors ranged from 1.3 to 11.0 cm in diameter. Thirty of the 31 patients (97%) had a positive FDG-PET study. There were 5 patients classified as TS1, 15 as TS2 and 11 as TS3-4. The sensitivity of FDG-PET, computed tomography (CT) and magnetic resonance imaging (MRI) were 100%, 40%, 0% in TS1, 93%, 93%, 89% in TS2 and 100%, 100%, 100% in TS3-4. The sensitivity of FDG-PET was significantly higher in comparison to CT and MRI in patients with TS1 (P < 0.032). The mean standardized uptake values (SUVs) did not show a significant difference in relation to the TS (TS1: 5.8 ± 4.5, TS2: 5.7 ± 2.2, TS3-4: 8.2 ± 3.9), respectively. All the TS1 tumors (from 13 to 20 mm) showed higher SUVs in FDG-PET with dual time point evaluation in the delayed phase compared with the early phase, which suggested the lesions were malignant.


CONCLUSIONS
These results indicate that FDG-PET with dual time point evaluation is a useful modality for the detection of small pancreatic cancers with a diameter of less than 20 mm.
Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan. kokano@kms.ac.jp
Keiichi
K
Okano
Keitaro
K
Kakinoki
Shintaro
S
Akamoto
Masanobu
M
Hagiike
Hisashi
H
Usuki
Yuka
Y
Yamamoto
Yoshihiro
Y
Nishiyama
Yasuyuki
Y
Suzuki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D049268:Positron-Emission Tomography / Q000379:methods*; D011788:Quality of Life; D019275:Radiopharmaceuticals / Q000494:pharmacology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
Cancer. 2000 Dec 15;89(12):2547-54
11135214
Radiology. 1997 Mar;202(3):655-62
9051012
Abdom Imaging. 1997 Mar-Apr;22(2):204-7
9013536
AJR Am J Roentgenol. 1999 Sep;173(3):583-90
10470884
J Gastrointest Surg. 2003 Dec;7(8):953-9; discussion 959-60
14675704
Hematol Oncol Clin North Am. 2002 Feb;16(1):1-16
12063821
AJR Am J Roentgenol. 1999 Aug;173(2):375-80
10430140
Eur J Gastroenterol Hepatol. 2000 Aug;12(8):869-77
10958214
J Hepatobiliary Pancreat Surg. 2006;13(5):435-41
17013719
Am J Gastroenterol. 2006 Jan;101(1):133-6
16405545
AJR Am J Roentgenol. 1998 May;170(5):1315-22
9574609
World J Gastroenterol. 2008 Jan 7;14(1):64-9
18176963
Cancer Detect Prev. 2003;27(2):87-93
12670518
Ann Nucl Med. 2009 Jan;23(1):49-57
19205838
Can J Gastroenterol. 2002 Feb;16(2):101-5
11875594
J Hepatobiliary Pancreat Surg. 2001;8(6):544-8
11956906
Dig Dis. 2001;19(1):6-14
11385246
Ann Intern Med. 2004 Nov 16;141(10):753-63
15545675
J Hepatobiliary Pancreat Surg. 2008;15(6):634-9
18987935
Nucl Med Commun. 2005 Oct;26(10):895-901
16160649
Semin Nucl Med. 2006 Jul;36(3):248-56
16762614
Pancreas. 1998 Apr;16(3):238-42
9548661