Abstract

Background: Complete resection of the primary tumor is one of the most important markers for successful surgery in patients with pancreatic adenocarcinoma. There is a significant increase in survival rate when there is a visible tumor-free margin of more than 1 mm. Currently, the pancreatic and the bile duct transection margins are perioperatively assessed using frozen section analysis which is time consuming and labor intensive. Moreover, it does not allow the assessment of all resection margins and is prone to sampling bias. We therefore aim to investigate the use of high-resolution 18F-fluoro-deoxyglucose (FDG) positron emission tomography (PET) and X-ray computed tomography (CT) for fast perioperative 3D imaging of the complete specimen in order to assess the full transection and dissection margins. In this proof-of-concept study, we take a first step in this direction by assessing the feasibility of high-resolution 18F-FDG-PET-CT to visualize pancreatic tumors.

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