title: Role of SUV(max) obtained by 18F-FDG PET/CT in patients with a solitary pancreatic lesion: predicting malignant potential and proliferation.
abstract: OBJECTIVE
  Maximum standardized uptake value (SUV(max)) is a marker of tumor glucose metabolism detected by [(18)F]-fluorodeoxyglucose ((18)F-FDG) PET/computed tomography (PET/CT) and reflects tumor aggressiveness. The aim of the study was to evaluate the value of SUV(max) in differentiating benign from malignant solitary pancreatic lesions and explore the correlation between SUV(max) and tumor proliferative activity.
  
  
  METHODS
  F-FDG PET/CT scans were performed in 80 patients with solitary pancreatic lesions who were scheduled for resective surgery. The relationships between SUV(max) and postoperative pathologic diagnosis, histologic grade, and Ki-67 proliferation index (PI) were analyzed.
  
  
  RESULTS
  Of these 80 patients, 54 had malignant lesions. The SUV(max) of malignant tumors (6.3 ± 2.4) was significantly greater than that of benign lesions (2.9 ± 2.0) (P<0.001). Receiver-operating characteristic curve analysis showed that the SUV(max) cutoff value of 3.5 had a high sensitivity (92.6%) and specificity (76.9%) for the diagnosis of malignancies. Among pancreatic cancers with low (Ki-67<5%), moderate (5% ≤ Ki-67<50%), and high (Ki-67 ≥ 50%) PI, SUV(max) increased significantly from 4.2 ± 1.2, through 6.0 ± 1.7, to 8.6 ± 2.5 (P<0.001). The SUV(max) had a positive correlation with Ki-67 PI (P<0.001, r=0.60).
  
  
  CONCLUSIONS
  The SUV(max) of F-FDG PET/CT can be used in the differential diagnosis of solitary pancreatic lesions and can also aid in the prediction of proliferative activity of pancreatic cancer.
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Si-Long
authors.initials: SL
authors.lastname: Hu
authors.forename: Zhong-Yi
authors.initials: ZY
authors.lastname: Yang
authors.forename: Zheng-Rong
authors.initials: ZR
authors.lastname: Zhou
authors.forename: Xian-Jun
authors.initials: XJ
authors.lastname: Yu
authors.forename: Bo
authors.initials: B
authors.lastname: Ping
authors.forename: Ying-Jian
authors.initials: YJ
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D049109:Cell Proliferation; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019394:Ki-67 Antigen; D019788:Fluorodeoxyglucose F18