The role of 18fluoro-deoxyglucose positron emission tomography/computed tomography in resectable pancreatic cancer

Stefano Crippa, Matteo Salgarello, Silvia Laiti, Stefano Partelli, Paola Castelli, Antonello E. Spinelli, Domenico Tamburrino, Giuseppe Zamboni, Massimo Falconi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The role of 18fluoro-deoxyglucose positron emission tomography/computed tomography in pancreatic ductal adenocarcinoma is debated. We retrospectively assessed the value of 18fluoro-deoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer. Methods: 18Fluoro-deoxyglucose positron emission tomography/computed tomography was performed in 72 patients with resectable pancreatic carcinoma after multi-detector computed tomography positron emission tomography was considered positive for a maximum standardized uptake value >3. Results: Overall, 21% of patients had a maximum standardized uptake value ≤3, and 60% of those had undergone neoadjuvant treatment (P= 0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8. U/mL for the entire cohort and 292. U/mL for metastatic patients (P= 0.112). Conclusions: The widespread application of 18fluoro-deoxyglucose positron emission tomography/computed tomography in patients with resectable pancreatic carcinoma seems not justified. It should be considered in selected patients at higher risk of metastatic disease (i.e. CA19.9>200U/mL) after undergoing other imaging tests. Neoadjuvant treatment is significantly associated with low metabolic activity, limiting the value of positron emission tomography in this setting.

Original languageEnglish
Pages (from-to)744-749
Number of pages6
JournalDigestive and Liver Disease
Volume46
Issue number8
DOIs
Publication statusPublished - 2014

Keywords

  • Computed tomography
  • Liver
  • Lymph node
  • Metastases
  • Pancreatic cancer
  • Positron emission tomography
  • Staging

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

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