F-18-fluorodeoxyglucose positron emission tomography in differentiating malignant from benign pancreatic cysts: A prospective study |
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Authors: | Cosimo?Sperti Claudio?Pasquali Giandomenico?Decet Franca?Chierichetti Guido?Liessi Email author" target="_blank">Sergio?PedrazzoliEmail author |
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Institution: | (1) Department of Medical and Surgical Sciences, University of Padua, Padova, Italy;(2) Department of Nuclear Medicine, Castelfranco Hospital, Castelfranco Veneto, Treviso, Italy;(3) Department of Radiology, Castelfranco Hospital, Castelfranco Veneto, Treviso, Italy;(4) Dipartimento di Scienze Mediche e Chirurgiche Direttore Sezione di Clinica Chirurgica IV, Università degli Studi di Padova, Ospedale Giustinianeo, Via Giustiniani, 2, 35128 Padova, Italy |
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Abstract: | The differential diagnosis between benign and malignant pancreatic cystic lesions may be very difficult. We recently found
that F-18-.uorodeoxyglucose positron emission tomography (18-FDG PET) was useful for the preoperative work-up of pancreatic
cystic lesions. This study was undertaken to confirm these results. From February 2000 to July 2003, 50 patients with a pancreatic
cystic lesion were prospectively investigated with 18-FDG PET in addition to helical computed tomography (CT) and, in some
instances, magnetic resonance imaging (MRI). The validation of diagnosis was based on pathologic findings after surgery (n
= 31), percutaneous biopsy (n = 4), and according to follow-up in 15 patients. The 18-FDG PET was analyzed visually and semiquantitatively
using the standard uptake value (SUV). The accuracy of FDG PET and CT was determined for preoperative diagnosis of malignant
cystic lesions. Seventeen patients had malignant cystic lesions. Sixteen (94%) showed increased 18-FDG uptake (SUV >2.5),
including two patients with carcinoma in situ. Eleven patients (65%) were correctly identified as having malignancy by CT.
Thirty-three patients had benign tumors: two patients showed increased 18-FDG uptake, and four patients showed CT findings
of malignancy. Sensitivity, specificity, positive and negative predictive value, and accuracy of 18-FDG PET and CT in detecting
malignant tumors were 94%, 94%, 89%, 97%, and 94% and 65%, 88%, 73%, 83%, and 80%, respectively. 18-FDG PET is accurate in
identifying malignant pancreatic cystic lesions and should be used in combination with CT in the preoperative evaluation of
patients with pancreatic cystic lesions. A negative result with 18-FDG PET may avoid unnecessary operation in asymptomatic
or high-risk patients.
Presented at the Forty-Fifth Annual Meeting of The Society for Surgery of the Alimentary Tract, New Orleans, Louisiana, May
15–19, 2004 (oral presentation).
This study was supported by the Ministero Università e Ricerca Scientifica (Cofin 2001068593-001), Rome, Italy. |
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Keywords: | Pancreas cystic lesions intraductal papillary mucinous tumor mucinous cystadenoma serous cystadenoma positron emission tomography benign pancreatic cysts |
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