Clinical utility of positron emission tomography in the diagnosis and management of periampullary neoplasms |
| |
Authors: | Matthew?F?Kalady Bryan?M?Clary Lisa?A?Clark Marcia?Gottfried Eric?M?Rohren R?Edward Coleman Theodore?N?Pappas Email author" target="_blank">Douglas?S?TylerEmail author |
| |
Institution: | (1) Department of Surgery, Duke University Medical Center, Box 3118, 27710 Durham, NC;(2) Department of Pathology, Duke University Medical Center, Box 3118, 27710 Durham, NC;(3) Department of Radiology, Duke University Medical Center, Box 3118, 27710 Durham, NC |
| |
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. |
| |
Keywords: | Pancreatic cancer Positron emission tomography Computed tomography Diagnostic imaging Periampullary cancer |
本文献已被 PubMed SpringerLink 等数据库收录! |
|