title: Role of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in the characterization of pancreatic masses: experience from tropics.
abstract: OBJECTIVE
  Early detection and differentiation of malignant from benign pancreatic tumors is very essential as mass-forming pancreatitis is a frequently encountered problem. Positron emission tomography (PET) has a role in establishing the diagnosis of pancreatic carcinoma when the conventional imaging modalities or biopsies are nondiagnostic. In this prospective study, the utility of fluorodeoxyglucose (FDG)-PET/computed tomography (CT) in the characterization of mass-forming lesions of the pancreas was reported.
  
  
  METHODS
  (18)F-FDG-PET/CT was prospectively performed in 87 patients diagnosed to have periampullary or pancreatic mass. Lesions with focally increased FDG uptake in PET/CT were considered malignant, whereas those with diffuse or no FDG uptake were considered benign. Semiquantitative analysis with maximum standardized uptake value (SUVmax) was also calculated. The PET/CT results were compared with histopathological results in all patients.
  
  
  RESULTS
  Based on the FDG uptake pattern, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for FDG-PET/CT in characterizing the periampullary and pancreatic masses into benign and malignant lesions were 93%, 90%, 95%, 87%, and 92% respectively. Receiver operating characteristics curve analysis of the SUVmax of the lesions yielded a cut-off value of 2.8, with a sensitivity and specificity of 87.5% and 45% respectively.
  
  
  CONCLUSIONS
  The FDG uptake pattern in PET/CT can differentiate malignant from benign mass-forming lesions of the pancreas with high accuracy and a discrete cut-off value of SUVmax could not be defined for the same as even lesions with pancreatic tuberculosis showed very high FDG uptake. Hence, in patients with a suspicion of malignancy in the pancreas, a focally increase FDG uptake in PET/CT suggests the diagnosis of malignancy.
authors.affiliation: Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sampath
authors.initials: S
authors.lastname: Santhosh
authors.forename: Bhagwant Rai
authors.initials: BR
authors.lastname: Mittal
authors.forename: Deepak
authors.initials: D
authors.lastname: Bhasin
authors.forename: Radhika
authors.initials: R
authors.lastname: Srinivasan
authors.forename: Surinder
authors.initials: S
authors.lastname: Rana
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.forename: Ritambhra
authors.initials: R
authors.lastname: Nada
authors.forename: Anish
authors.initials: A
authors.lastname: Bhattacharya
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kapoor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18