title: Limited efficacy of (18)F-FDG PET/CT for differentiation between metastasis-free pancreatic cancer and mass-forming pancreatitis.
abstract: OBJECTIVE
  Differentiation between metastasis-free pancreatic cancer and mass-forming pancreatitis is important to avoid unnecessary operative procedures. This study was aimed at evaluating the efficacy of PET/CT with F-FDG (FDG PET/CT) for the differential diagnosis between them.
  
  
  METHODS
  FDG-PET/CT was performed in 47 study patients with pancreatic masses and without any detectable metastases, 33 of which cases were finally diagnosed as pancreatic cancer and the other 14 as pancreatitis, and the corresponding imaging data were evaluated retrospectively. The maximal SUV (SUVmax) within the masses were determined at 1 hour and mostly at 2 hours after intravenous injection of FDG.
  
  
  RESULTS
  SUVmax at 1 hour in pancreatic cancer was significantly higher than that in mass-forming pancreatitis, and the change in SUVmax from 1- to 2-hour time points was more consistent with pancreatic cancer than with mass-forming pancreatitis. However, there remained considerable overlapping between the SUVmax values of both diseases except either at the higher range for pancreatic cancer (> 7.7 at 1 hour or > 9.98 at 2 hours) or at the lower range for mass-forming pancreatitis (<3.37 at 1 hour or <3.53 at 2 hours). No obvious difference was found in the FDG uptake patterns of the mass areas between both diseases.
  
  
  CONCLUSIONS
  Differentiation between metastasis-free pancreatic cancer and mass-forming pancreatitis is difficult by FDG-PET/CT due to considerable overlapping between the SUVmax values of the two diseases, although the differential diagnosis may be possible either at the higher range of SUVmax (> 7.7 at 1 hour or > 9.98 at 2 hours) for pancreatic cancer or at the lower range of SUVmax (<3.37 at 1 hour or <3.53 at 2 hours) for mass-forming pancreatitis.
authors.affiliation: Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan. katokt@med.nagoya-u.ac.jp
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kato
authors.forename: Takashi
authors.initials: T
authors.lastname: Nihashi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ikeda
authors.forename: Shinji
authors.initials: S
authors.lastname: Abe
authors.forename: Shingo
authors.initials: S
authors.lastname: Iwano
authors.forename: Shigeki
authors.initials: S
authors.lastname: Itoh
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shimamoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D010195:Pancreatitis / Q000000981:diagnostic imaging*; D011859:Radiography; D011877:Radionuclide Imaging
chemical_list: D019788:Fluorodeoxyglucose F18