Comparing the performance of visual estimation and standard uptake value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography for detecting malignancy in pancreatic tumors other than invasive ductal carcinoma.
BACKGROUND
The utility of FDG PET/CT for the detection and evaluation of invasive ductal carcinoma has been widely reported, but a few studies have assessed the utility of FDG PET/CT to detect malignancy in a variety of pancreatic lesions other than invasive ductal carcinoma.


OBJECTIVE
To compare the diagnostic performance of visual estimation with the semi-quantitative scores of FDG PET/CT for detecting malignancy in a variety of pancreatic lesions other than invasive ductal carcinoma.


METHODS
Images of pathologically proven pancreatic lesions from 32 patients were retrospectively evaluated: 14 benign lesions, 7 borderline (low malignant) lesions, and 11 malignant lesions. The average scores from visual estimation by the two observers were compared to two semi-quantitative analyses of FDG uptake in the lesions, namely the maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean).


RESULTS
Visual analysis value, SUVmax and SUVmean were 0.33 ± 0.21, 1.8 ± 0.7 and 1.5 ± 0.7 for the benign lesions, 0.70 ± 0.28, 5.0 ± 2.6 and 3.1±1.7 for the borderline lesions, and 0.73 ± 0.18, 4.7 ± 2.5 and 3.2 ± 1.6 for the malignant lesions, respectively. Receiver operating characteristic analysis revealed the areas under the curves for detecting non-benign (malignant or borderline) lesions through visual analysis, SUVmax, and SUVmean were 0.914, 0.954, and 0.875, respectively.


CONCLUSIONS
For a variety of pancreatic lesions other than invasive ductal carcinoma, visual analysis and semi-quantitative analyses all showed strong diagnostic performance. However, semi-quantitative analysis with SUVmax proved to be the most effective method for detecting non-benign pancreatic lesions.
Departments of Radiology, Institute of Health Bioscience, the University of Tokushima Graduate School.
Yoichi
Y
Otomi
Hideki
H
Otsuka
Kaori
K
Terazawa
Hayato
H
Nose
Michiko
M
Kubo
Kenji
K
Matsuzaki
Hitoshi
H
Ikushima
Yoshimi
Y
Bando
Masafumi
M
Harada
D000236:Adenoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D018293:Cystadenoma, Serous / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010179:Pancreas / Q000000981:diagnostic imaging / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18