Abstract
Background
This study examined the effect that 18-fluorodeoxyglucose positron emission tomography (18FDG-PET) imaging had on the clinical management of patients with suspected periampullary malignancy.
Methods
Fifty-four patients with suspected pancreatic neoplasms underwent both whole-body18FDG-PET and abdominal computed tomography (CT). Malignant or benign disease was confirmed pathologically in 47 patients.
Results
Of the 41 patients with malignancy,18FDG-PET failed to identify the primary tumor in 5 patients.18FDG-PET demonstrated increased uptake suggesting primary malignancy in 37 patients. Malignant pathology was confirmed in 36 cases.18FDG-PET identified malignant locoregional lymph node metastases in six of ten patients. All nodes identified before surgery by18FDG-PET were also seen on preoperative CT. Six patients who were thought to have resectable disease by CT were found to have distant metastasis at laparotomy.18FDG-PET did not detect metastasis in any of these cases. Before surgery,18FDG-PET identified distant metastases that were not detected by CT in one patient.
Conclusions
Despite high sensitivity and specificity in diagnosing periampullary malignancy,18FDG-PET did not change clinical management in the vast majority of patients previously evaluated by CT. In addition,18FDG-PET missed>10% of periampullary malignancies and did not provide the anatomical detail necessary to define unresectability.
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Kalady, M.F., Clary, B.M., Clark, L.A. et al. Clinical utility of positron emission tomography in the diagnosis and management of periampullary neoplasms. Annals of Surgical Oncology 9, 799–806 (2002). https://doi.org/10.1007/BF02574503
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DOI: https://doi.org/10.1007/BF02574503