Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2015; 21(10): 2988-2996
Published online Mar 14, 2015. doi: 10.3748/wjg.v21.i10.2988
Cross-modality PET/CT and contrast-enhanced CT imaging for pancreatic cancer
Jian Zhang, Chang-Jing Zuo, Ning-Yang Jia, Jian-Hua Wang, Sheng-Ping Hu, Zhong-Fei Yu, Yuan Zheng, An-Yu Zhang, Xiao-Yuan Feng
Jian Zhang, Chang-Jing Zuo, Sheng-Ping Hu, An-Yu Zhang, Department of Nuclear Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
Ning-Yang Jia, Department of Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433, China
Jian-Hua Wang, Department of Radiology, the Affiliated Hospital of Medical School of Ningbo University, Ningbo 305020, Zhejiang Province, China
Zhong-Fei Yu, Department of PET/CT Center, No. 411 Hospital of PLA, Shanghai 200081, China
Yuan Zheng, Department of Radiology, No. 85 Hospital of PLA, Shanghai 200052, China
Xiao-Yuan Feng, Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
Author contributions: Zhang J, Jia NY and Feng XY designed the study and analyzed the data; Zuo CJ and Zhang AY analyzed the data and contributed to the data interpretation; Zuo CJ, Wang JH, Hu SP, Yu ZF and Zheng Y reviewed the FDG-PET/CT images and contributed to the materials; Wang JH and Zheng Y reviewed the CECT data and contributed to the materials; Zhang J and Jia NY wrote the manuscript; Zhang J, Zuo CJ and Jia NY contributed equally to this work.
Supported by National Natural Science Foundation of China, No. 81170435, No. 81301218 and No. 81301262; China Postdoctoral Science Foundation, No. 20100480545; International Cooperation Fund of Shanghai Science and Technology Commission, No. 10410708800; Shanghai Municipal Health Bureau projects, No. XBR2011040; and Ningbo Natural Science Foundation, No. 2010A610052.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Yuan Feng, MD, Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai 200040, China. xyfeng@shmu.edu.cn
Telephone: +86-21-31162238 Fax: +86-21-31162238
Received: July 9, 2014
Peer-review started: July 10, 2014
First decision: August 15, 2014
Revised: September 25, 2014
Accepted: November 18, 2014
Article in press: November 19, 2014
Published online: March 14, 2015
Abstract

AIM: To explore the diagnostic value of the cross-modality fusion images provided by positron emission tomography/computed tomography (PET/CT) and contrast-enhanced CT (CECT) for pancreatic cancer (PC).

METHODS: Data from 70 patients with pancreatic lesions who underwent CECT and PET/CT examinations at our hospital from August 2010 to October 2012 were analyzed. PET/CECT for the cross-modality image fusion was obtained using TureD software. The diagnostic efficiencies of PET/CT, CECT and PET/CECT were calculated and compared with each other using a χ2 test. P < 0.05 was considered to indicate statistical significance.

RESULTS: Of the total 70 patients, 50 had PC and 20 had benign lesions. The differences in the sensitivity, negative predictive value (NPV), and accuracy between CECT and PET/CECT in detecting PC were statistically significant (P < 0.05 for each). In 15 of the 31 patients with PC who underwent a surgical operation, peripancreatic vessel invasion was verified. The differences in the sensitivity, positive predictive value, NPV, and accuracy of CECT vs PET/CT and PET/CECT vs PET/CT in diagnosing peripancreatic vessel invasion were statistically significant (P < 0.05 for each). In 19 of the 31 patients with PC who underwent a surgical operation, regional lymph node metastasis was verified by postsurgical histology. There was no statistically significant difference among the three methods in detecting regional lymph node metastasis (P > 0.05 for each). In 17 of the 50 patients with PC confirmed by histology or clinical follow-up, distant metastasis was confirmed. The differences in the sensitivity and NPV between CECT and PET/CECT in detecting distant metastasis were statistically significant (P < 0.05 for each).

CONCLUSION: Cross-modality image fusion of PET/CT and CECT is a convenient and effective method that can be used to diagnose and stage PC, compensating for the defects of PET/CT and CECT when they are conducted individually.

Keywords: Pancreatic neoplasms, Positron-emission tomography, Tomography, X-ray computed, Contrast enhancement, Diagnostic imaging, Staging

Core tip: Accurate pancreatic cancer (PC) diagnosis and staging are essential to choosing appropriate treatments and providing a more accurate prognosis. Combined contrast-enhanced positron emission tomography and computed tomography (PET/CT) can improve the information obtained from PET/CT or contrast-enhanced CT (CECT) alone. However, many patients with pancreatic disease have already undergone CECT examination by the time they undergo 18F-fluorodeoxyglucose PET/CT scanning. The aim of this study was to explore the value of the cross-modality fusion images provided by PET/CT and CECT in PC. We found that it is a convenient and effective method for diagnosing and staging pancreatic cancer to compensate for some of the defects of PET/CT and CECT alone.