36 - Chronic Pancreatitis versus Pancreatic Cancer: Positron Emission Tomography

Abstract

Early diagnosis and accurate staging of pancreatic cancer is critical in determining the treatment. Differential diagnosis between benign and malignant pancreatic tumors is particularly important because the prognosis of malignant pancreatic tumor is very poor, and it is curable only by surgical resection in its early stage. Recent advances in imaging techniques have contributed to an early and accurate diagnosis of pancreatic cancer. Computed tomography (CT), endoscopic ultrasonography (EUS), endoscopic retrograde cholangiopancreatography (ERCP), and magnetic resonance cholangiopancreatography (MRCP) are commonly used imaging modalities in detecting pancreatic cancer. Fluorine-18 deoxyglucose positron emission tomography (FDG-PET) has evolved as an additional modality, which sensitively detects the pancreatic cancer using different metabolic statuses of cancer tissue. FDG, a glucose analog, is highly metabolized in tumor cells as an energy source and a carbon backbone for DNA and RNA synthesis. Therefore, it is suitable to detect a tumor with a high proliferation rate. Although CT and MR imaging are advantageous in providing precise anatomical delineation of pancreatic lesions, they are less specific in differentiating malignant and benign lesions. In contrast, FDG-PET is useful in detecting altered metabolic activity in malignant tumors, although it is less sensitive in detecting anatomical localization of the tumor.