The Utility of F-18 Fluorodeoxyglucose Whole Body PET Imaging for Determining Malignancy in Cystic Lesions of the Pancreas

John C. Mansour, Lawrence Schwartz, Neeta Pandit-Taskar, Michael D'Angelica, Yuman Fong, Steven M. Larson, Murray F Brennan, Peter J. Allen

Research output: Contribution to journalArticle

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Abstract

Previous studies have suggested that whole body positron-emission tomography (PET) can distinguish between benign and malignant cysts of the pancreas. Patients were identified (n = 68) who had undergone whole body PET imaging for a cystic lesion of the pancreas between Jan. 1997 and May 2005. Cross-sectional imaging studies were reviewed by a single blinded radiologist, and positive PET studies were reviewed by a blinded nuclear medicine physician. Operative resection was performed in 21 patients (31%), and 47 patients were managed with radiographic follow-up. F-18 Fluorodeoxyglucose (FDG)-avid lesions were identified in eight of the 68 patients (12%). Within the resected group of patients (n = 21), four of the seven patients (57%) with either in situ or invasive malignancy (adenocarcinoma: 3 of 5, papillary mucinous carcinoma: 1 of 2) had positive PET imaging (mean SUV, 5.9; range 2.5-8.0), and 2 of the 14 patients (14%) with benign lesions had positive PET imaging (serous cystadenoma, n = 1, SUV = 3.3; pseudocyst n = 1, SUV = 2.7). All lesions proven to be malignant with increased FDG uptake had highly suspicious findings on cross-sectional imaging. Within the group of resected patients, the sensitivity of PET for identifying malignant pathology was 57%, and the specificity was 85%. The sensitivity and specificity of PET for malignancy in this study was lower than previously reported, and PET findings did not identify otherwise occult malignant cysts. We do not believe whole body FDG-PET to be essential in the evaluation of cystic lesions of the pancreas.

Original languageEnglish (US)
Pages (from-to)1354-1360
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume10
Issue number10
DOIs
StatePublished - Dec 2006

Fingerprint

Fluorodeoxyglucose F18
Positron-Emission Tomography
Pancreas
Neoplasms
Cysts
Serous Cystadenoma
Mucinous Adenocarcinoma
Papillary Carcinoma
Nuclear Medicine
Adenocarcinoma
Cross-Sectional Studies
Pathology
Physicians
Sensitivity and Specificity

Keywords

  • cyst
  • Pancreas
  • PET scan

ASJC Scopus subject areas

  • Surgery

Cite this

The Utility of F-18 Fluorodeoxyglucose Whole Body PET Imaging for Determining Malignancy in Cystic Lesions of the Pancreas. / Mansour, John C.; Schwartz, Lawrence; Pandit-Taskar, Neeta; D'Angelica, Michael; Fong, Yuman; Larson, Steven M.; Brennan, Murray F; Allen, Peter J.

In: Journal of Gastrointestinal Surgery, Vol. 10, No. 10, 12.2006, p. 1354-1360.

Research output: Contribution to journalArticle

Mansour, John C. ; Schwartz, Lawrence ; Pandit-Taskar, Neeta ; D'Angelica, Michael ; Fong, Yuman ; Larson, Steven M. ; Brennan, Murray F ; Allen, Peter J. / The Utility of F-18 Fluorodeoxyglucose Whole Body PET Imaging for Determining Malignancy in Cystic Lesions of the Pancreas. In: Journal of Gastrointestinal Surgery. 2006 ; Vol. 10, No. 10. pp. 1354-1360.
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abstract = "Previous studies have suggested that whole body positron-emission tomography (PET) can distinguish between benign and malignant cysts of the pancreas. Patients were identified (n = 68) who had undergone whole body PET imaging for a cystic lesion of the pancreas between Jan. 1997 and May 2005. Cross-sectional imaging studies were reviewed by a single blinded radiologist, and positive PET studies were reviewed by a blinded nuclear medicine physician. Operative resection was performed in 21 patients (31{\%}), and 47 patients were managed with radiographic follow-up. F-18 Fluorodeoxyglucose (FDG)-avid lesions were identified in eight of the 68 patients (12{\%}). Within the resected group of patients (n = 21), four of the seven patients (57{\%}) with either in situ or invasive malignancy (adenocarcinoma: 3 of 5, papillary mucinous carcinoma: 1 of 2) had positive PET imaging (mean SUV, 5.9; range 2.5-8.0), and 2 of the 14 patients (14{\%}) with benign lesions had positive PET imaging (serous cystadenoma, n = 1, SUV = 3.3; pseudocyst n = 1, SUV = 2.7). All lesions proven to be malignant with increased FDG uptake had highly suspicious findings on cross-sectional imaging. Within the group of resected patients, the sensitivity of PET for identifying malignant pathology was 57{\%}, and the specificity was 85{\%}. The sensitivity and specificity of PET for malignancy in this study was lower than previously reported, and PET findings did not identify otherwise occult malignant cysts. We do not believe whole body FDG-PET to be essential in the evaluation of cystic lesions of the pancreas.",
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