title: Utility of 18 fludeoxyglucose in preoperative positon-emission tomography-computed tomography (PET-CT) in the early diagnosis of exocrine pancreatic cancer: A study of 139 resected cases.
abstract: BACKGROUND
  In pancreatic ductal adenocarcinoma (PDA), surgical resection is the only curative treatment, but due to its late clinical presentation only 15-25% patients are candidates for curative resection. The aim of this prospective, single-center study is to determine the diagnostic utility of preoperative PET-CT for early detection of PDA and early panIN lesions.
  
  
  METHODS
  We studied the histopathological features of PDA and different panIN lesions in 139 surgical samples from patients undergoing pancreatic resection (from 2010-2014), comparing these results with preoperative PET-CT and MDCT study. For tumor diagnosis in PET-CT maximum standard SUV 2.5 was used. Pancreatic baseline SUVmax is the maximum uptake of the radiotracer 18-2FDG on the ROI curve determined for the area of the normal pancreas after pathological reassessment with areas not affected by tumours or preneoplastic lesions. Tumour Uptake Index is the ratio between the tumour SUVmax and pancreatic baseline SUVmax.
  
  
  RESULTS
  Using an standard maximum SUV value of 2.5, PET-CT sensitivity was 77.7% (108 of the 139 cases) against 75.5% (105 of the 139 cases) of MDCT. But when we combined this value with maximum SUV of normal pancreatic tissue from each patient, PET-CT sensitivity improved its value to 94.9%.
  
  
  CONCLUSIONS
  A combination of studies of PET-CT in tumor and non-tumor tissue of each patient might be a very useful diagnostic tool not only for preoperative diagnosis of PDA, but also for early panIN lesions.
authors.affiliation: Servicio de Cirugía, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB ARRIXACA), Murcia, España. Electronic address: sbuenof@um.es.
authors.forename: Francisco
authors.initials: F
authors.lastname: Sánchez-Bueno
authors.affiliation: Servicio de Cirugía, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB ARRIXACA), Murcia, España.
authors.forename: Rocío
authors.initials: R
authors.lastname: García-Pérez
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB ARRIXACA), Murcia, España.
authors.forename: María Antonia
authors.initials: MA
authors.lastname: Claver Valderas
authors.affiliation: Servicio de Anatomía Patológica, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB ARRIXACA), Murcia, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: de la Peña Moral
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB ARRIXACA), Murcia, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Frutos Esteban
authors.affiliation: Servicio de Anatomía Patológica, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB ARRIXACA), Murcia, España.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ortiz Ruiz
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB ARRIXACA), Murcia, España.
authors.forename: Matilde
authors.initials: M
authors.lastname: Fuster Quiñonero
authors.affiliation: Servicio de Cirugía, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB ARRIXACA), Murcia, España.
authors.forename: Pascual
authors.initials: P
authors.lastname: Parrilla Paricio
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D000072078:Positron Emission Tomography Computed Tomography; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Adenocarcinoma ductal de páncreas; Cirugía pancreática; Neoplasia intraepitelial pancreática; Pancreas surgery; Pancreatic ductal adenocarcinoma; Pancreatic intraepithelial neoplasia; Positron-emission tomography-computed tomography (PET-CT); Tomografía por emisión de positrones-tomografía computarizada (PET-TC)