F-18 fluorodeoxyglucose PET in vivo evaluation of pancreatic glucose metabolism for detection of pancreatic cancer.

Abstract

To evaluate positron emission tomography (PET) with fluorine-18-labeled fluorodeoxyglucose (FDG) for detection of pancreatic cancer compared with computed tomography (CT) and ultrasonography (US). Forty patients with suspected pancreatic cancer underwent static PET after intravenous injection of 150-300 MBq FDG. Focal FDG accumulation was regarded as a sign of malignancy and was quantitated by calculating differential uptake ratios (DURs) and tumor-liver ratios (TLRs). Malignancy was histologically proved in 27 patients. PET helped correctly classify 25 of 27 malignant conditions and 11 of 13 benign disorders. DUR and TLR were statistically significantly higher in malignant compared with benign disease (P < .01). False-negative findings were obtained in patients with insulin-dependent diabetes. False-positive findings were noted in a patient with retroperitoneal fibrosis and in one with pancreas divisum with chronic pancreatitis. PET was superior to CT and US in detection of lymph node metastases (13 of 17 vs three of 17 or one of 15, respectively. FDG PET has the potential to improve the detection of lymphadenopathy and the differential diagnosis of pancreatic masses.