Document Detail

Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography.
MedLine Citation:
PMID:  18306988     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely used for the diagnosis of pancreatic cancer. Because autoimmune pancreatitis is easily misdiagnosed as pancreatic cancer and can be tested for by FDG-PET analysis based on the presence of suspected pancreatic cancer, we attempted to clarify the differences in FDG-PET findings between the two conditions. METHODS: We compared FDG-PET findings between 15 patients with autoimmune pancreatitis and 26 patients with pancreatic cancer. The findings were evaluated visually or semiquantitatively using the maximum standardized uptake value and the accumulation pattern of FDG. RESULTS: FDG uptake was found in all 15 patients with autoimmune pancreatitis, whereas it was found in 19 of 26 patients (73.1%) with pancreatic cancer. An accumulation pattern characterized by nodular shapes was significantly more frequent in pancreatic cancer, whereas a longitudinal shape indicated autoimmune pancreatitis. Heterogeneous accumulation was found in almost all cases of autoimmune pancreatitis, whereas homogeneous accumulation was found in pancreatic cancer. Significantly more cases of pancreatic cancer showed solitary localization, whereas multiple localization in the pancreas favored the presence of autoimmune pancreatitis. FDG uptake by the hilar lymph node was significantly more frequent in autoimmune pancreatitis than in pancreatic cancer, and uptake by the lachrymal gland, salivary gland, biliary duct, retroperitoneal space, and prostate were seen only in autoimmune pancreatitis. CONCLUSIONS: FDG-PET is a useful tool for differentiating autoimmune pancreatitis from suspected pancreatic cancer, if the accumulation pattern and extrapancreatic involvement are considered. IgG4 measurement and other current image tests can further confirm the diagnosis.
Yayoi Ozaki; Kazuhiro Oguchi; Hideaki Hamano; Norikazu Arakura; Takashi Muraki; Kendo Kiyosawa; Mitsuhiro Momose; Masumi Kadoya; Kazunobu Miyata; Takao Aizawa; Shigeyuki Kawa
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-29
Journal Detail:
Title:  Journal of gastroenterology     Volume:  43     ISSN:  0944-1174     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  144-51     Citation Subset:  IM    
Department of Medicine, Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
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MeSH Terms
Adenocarcinoma / radionuclide imaging*
Autoimmune Diseases / diagnosis*
Diagnosis, Differential
Fluorodeoxyglucose F18 / diagnostic use
Middle Aged
Pancreatic Neoplasms / radionuclide imaging*
Pancreatitis / immunology,  radionuclide imaging*
Positron-Emission Tomography*
Radiopharmaceuticals / diagnostic use
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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