Document Detail

Diagnostic impact of 18F-FDG PET-CT evaluating solid pancreatic lesions versus endosonography, endoscopic retrograde cholangio-pancreatography with intraductal ultrasonography and abdominal ultrasound.
MedLine Citation:
PMID:  18481063     Owner:  NLM     Status:  MEDLINE    
PURPOSE: This prospective single-centre phase II trial assessed the diagnostic impact of (18)F-FDG PET-CT in the evaluation of solid pancreatic lesions (phi >or= 10 mm) compared to endosonography (EUS), endoscopic retrograde cholangio-pancreatography (ERCP) with intraductal ultrasound (IDUS), abdominal ultrasound (US) and histopathological reference. METHODS: Forty-six patients (32 men/14 women, phi 61.7 years) with suspected pancreatic neoplasms underwent PET-CT with contrast-enhanced biphasic multi-detector CT of the upper abdomen followed by a diagnostic work-up with EUS, ERCP with IDUS and US within 3 weeks. PET-CT data sets were analysed by two expert readers in a consensus reading. Histology from surgery, biopsy/fine-needle aspiration and/or clinical follow-up >or=12 months served as standard of reference. RESULTS: Twenty-seven pancreatic malignancies were histopathologically proven; 19 patients had benign diseases: 36/46 lesions (78%) were detected in the head of the pancreas, 7/46 and 3/46 in the body and tail region, respectively. Sensitivity and specificity of PET-CT were 89% and 74%, respectively; positive predictive value (PPV) and negative predictive value (NPV) were 83% and 82%, respectively. Sensitivity (81-89%), specificity (74-88%), PPV (83-90%) and NPV (77-82%) achieved by EUS, ERCP and US were not significantly different. PET analysis revealed significantly higher maximum mean standardised uptake values (SUV(max) 6.5+/-4.6) in patients with pancreatic malignancy (benign lesions: SUV(max) 4.2+/-1.5; p<0.05). PET-CT revealed cervical lymphonodal metastasis from occult bronchogenic carcinoma and a tubular colon adenoma with intermediate dysplasia on polypectomy, respectively. CONCLUSIONS: (18)F-FDG PET-CT achieves a comparably high diagnostic impact evaluating small solid pancreatic lesions versus conventional reference imaging modalities. Additional clinical diagnoses are derived from concomitant whole-body PET-CT imaging.
Verena Schick; Christiane Franzius; Torsten Beyna; May Lin Oei; Jürgen Schnekenburger; Matthias Weckesser; Wolfram Domschke; Otmar Schober; Walter Heindel; Thorsten Pohle; Kai Uwe Juergens
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Publication Detail:
Type:  Clinical Trial, Phase II; Comparative Study; Journal Article     Date:  2008-05-15
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  35     ISSN:  1619-7070     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-23     Completed Date:  2009-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1775-85     Citation Subset:  IM    
Department of Medicine B, Muenster University Hospital, Albert-Schweitzer-Strasse 33, 48149 Muenster, Germany.
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MeSH Terms
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde*
Endoscopy, Digestive System*
Fluorodeoxyglucose F18 / diagnostic use*
Middle Aged
Pancreatic Neoplasms / diagnosis*
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Subtraction Technique
Tomography, X-Ray Computed / methods*
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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