Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 14, 2011; 17(2): 231-235
Published online Jan 14, 2011. doi: 10.3748/wjg.v17.i2.231
18F-fluorodeoxyglucose positron emission tomography in the diagnosis of small pancreatic cancer
Keiichi Okano, Keitaro Kakinoki, Shintaro Akamoto, Masanobu Hagiike, Hisashi Usuki, Yuka Yamamoto, Yoshihiro Nishiyama, Yasuyuki Suzuki
Keiichi Okano, Keitaro Kakinoki, Shintaro Akamoto, Masanobu Hagiike, Hisashi Usuki, Yasuyuki Suzuki, Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Yuka Yamamoto, Yoshihiro Nishiyama, Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Author contributions: Okano K designed the study; Okano K and Nishiyama Y analyzed the data and wrote the manuscript; Okano K, Kakinoki K, Akamoto S, Hagiike M, Usuki H and Yamamoto Y acquired, analyzed and interpreted the data; Suzuki Y critically revised the manuscript.
Correspondence to: Keiichi Okano, MD, Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Kida-gun, Miki-cho, Kagawa 761-0793, Japan. kokano@kms.ac.jp
Telephone: +81-87-8985111 Fax: +81-87-8912186
Received: April 6, 2010
Revised: May 24, 2010
Accepted: May 31, 2010
Published online: January 14, 2011
Abstract

AIM: To investigate the role of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the diagnosis of small pancreatic cancer.

METHODS: This study involved 31 patients with proven invasive ductal cancer of the pancreas. The patients were divided into 3 groups according to the maximum diameter of the tumor: TS1 (maximum tumor size ≤ 2.0 cm), TS2 (> 2.0 cm and ≤ 4.0 cm) or TS3-4 (> 4.0 cm). The relationships between the TS and various diagnostic tools, including FDG-PET with dual time point evaluation, were analyzed.

RESULTS: The tumors ranged from 1.3 to 11.0 cm in diameter. Thirty of the 31 patients (97%) had a positive FDG-PET study. There were 5 patients classified as TS1, 15 as TS2 and 11 as TS3-4. The sensitivity of FDG-PET, computed tomography (CT) and magnetic resonance imaging (MRI) were 100%, 40%, 0% in TS1, 93%, 93%, 89% in TS2 and 100%, 100%, 100% in TS3-4. The sensitivity of FDG-PET was significantly higher in comparison to CT and MRI in patients with TS1 (P < 0.032). The mean standardized uptake values (SUVs) did not show a significant difference in relation to the TS (TS1: 5.8 ± 4.5, TS2: 5.7 ± 2.2, TS3-4: 8.2 ± 3.9), respectively. All the TS1 tumors (from 13 to 20 mm) showed higher SUVs in FDG-PET with dual time point evaluation in the delayed phase compared with the early phase, which suggested the lesions were malignant.

CONCLUSION: These results indicate that FDG-PET with dual time point evaluation is a useful modality for the detection of small pancreatic cancers with a diameter of less than 20 mm.

Keywords: Ductal carcinoma, Pancreas, 18F-fluorodeoxyglucose, Positron emission tomography, Pancreatic cancer, Dual time point evaluation