Abstract
Positron emission tomography with 2-deoxy-2-[18F]fluoro-D-glucose (FDG-PET) has been proven useful for differentiating pancreatic ductal cancer from mass-forming chronic pancreatitis. However, there are particular pancreatic tumors having various grades of malignancy such as intraductal papillary mucinous neoplasm (IPMN) or pancreatic neuroendocrine tumor. We examined whether the cut-off value of maximum standardized uptake value (SUVmax) determined by pancreatic ductal cancers is also applicable for other pancreatic tumors.One hundred thirty six patients with pancreatic tumors underwent FDG-PET imaging. We first analyzed the cut-off value to differentiate pancreatic ductal cancers from mass-forming chronic pancreatitis. Secondly, we determined the cut-off value between malignant IPMN and benign IPMN. Thirdly, we computed a cut-off value between malignant pancreatic tumors and benign tumors irrespective of tumor type.The optimal cut-off value to differentiate ductal cancers from mass-forming chronic pancreatitis was 2.5. The optimal cut-off value for differentiating malignant IPMN from benign IPMN was also 2.5, similar to that of reported studies. In all types of pancreatic tumors, the cut-off value was also 2.5. The accuracy for detecting malignancy was 93.4% for all tumors.In the FDG-PET study for pancreatic tumors, an SUVmax of 2.5 would be justified as a cut-off value to differentiate malignant lesions.
Highlights
Owing the progress of imaging modalities such as abdominal ultrasonography (US) and computed tomography (CT), accuracy in the diagnosis of pancreatic tumors has improved over the last decade
There was a significant difference between these groups (P < 0.01)
The optimal SUVmax to differentiate ductal cancer from massforming chronic pancreatitis was 2.5, which was determined as the point of the curve farthest from the chance line
Summary
Owing the progress of imaging modalities such as abdominal ultrasonography (US) and computed tomography (CT), accuracy in the diagnosis of pancreatic tumors has improved over the last decade. There are a variety of tumors such as ductal neoplasms, inflammatory and fibrotic tumors, and cystic tumors with malignant potentials of various degrees. Positron emission tomography using 2-deoxy-2-[18F] fluoro-D-glucose (FDG-PET) is a noninvasive, useful imaging modality. The usefulness of FDG-PET in differentiating pancreatic ductal cancer from massforming chronic pancreatitis has been reported. Maximum standardized uptake value (SUVmax) is a common parameter for evaluating the uptake by a mass lesion semi-quantitatively. This value is defined as the radioactivity of the tissue divided by the total radioactivity of the probe isotope injected per body weight (Sadato et al 1998).
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