title: Use of F-18 fluorodeoxyglucose positron emission tomography with dual-phase imaging to identify intraductal papillary mucinous neoplasm.
abstract: OBJECTIVE
  We investigated the usefulness of dual-phase F-18 fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) to differentiate benign from malignant intraductal papillary mucinous neoplasms (IPMNs) and to evaluate branch-duct IPMNs.
  
  
  METHODS
  We used FDG-PET/CT to evaluate IPMNs in 48 consecutive patients who underwent surgical resection from May 2004 to March 2012. IPMNs were classified as benign (n = 16) or malignant (n = 32) on the basis of histology analysis. The ability of FDG-PET/CT to identify branch-duct IPMNs was compared with that of the International Consensus Guidelines.
  
  
  RESULTS
  The maximum standardized uptake value (SUVmax) was higher for early-phase malignant IPMNs than that for benign IPMNs (3.5 ± 2.2 vs 1.5 ± 0.4, P < .001). When the SUVmax cutoff value was set at 2.0, early-phase malignant IPMNs were identified with 88% sensitivity, specificity, and accuracy. The retention index values for malignant and benign IPMNs were 19.6 ± 17.8 and -2.6 ± 12.9, respectively. When the SUVmax cutoff was set to 2.0 and the retention index value to -10.0, early-phase malignant IPMNs were identified with 88% sensitivity, 94% specificity, and 90% accuracy. In identification of branch-duct IPMNs, when the SUVmax cutoff was set to 2.0, the sensitivity, specificity, and accuracy values were 79%, 92%, and 84%, respectively. By using a maximum main pancreatic duct diameter ≥7 mm, the Guidelines identified branch-duct IPMNs with greater specificity than FDG-PET/CT. The Guidelines criteria of maximum cyst size ≥30 mm and the presence of intramural nodules identified branch-duct IPMNs with almost equal sensitivity to FDG-PET/CT.
  
  
  CONCLUSIONS
  Dual-phase FDG-PET/CT is useful for preoperative identification of malignant IPMN and for evaluating branch-duct IPMN.
authors.affiliation: Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan. sai_masa3110@yahoo.co.jp
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Saito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishihara
authors.forename: Motohisa
authors.initials: M
authors.lastname: Tada
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mikata
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakai
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Tawada
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Jo
authors.initials: J
authors.lastname: Kurosawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Otsuka
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Uchida
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18