EVALUATION OF PANCREATIC TUMORS WITH POSITRON EMISSION TOMOGRAPHY ANDF-18 FLUORODEOXYGLUCOSE - COMPARISON WITH CT AND US

PURPOSE: To assess the clinical value of positron emission tomography (PET) with fluorine-18-labeled fluorodeoxyglucose (FDG) for identifica tion of pancreatic carcinoma. MATERIALS AND METHODS: Forty-six patient s suspected of having a pancreatic neoplasm and who were to undergo su rgery prospectively underwent FDG PET, computed tomography (CT), and t ransabdominal ultrasound (US). Endoscopic US was performed in 40 patie nts. Images were independently interpreted and compared with the histo pathologic findings at surgery (41 patients) or with clinical follow-u p findings (five patients). RESULTS: In 33 of 35 patients, foci of pan creatic carcinomas (10-100 mm in diameter) were identified as an incre ase in FDG uptake, whereas CT, transabdominal US, and endoscopic US de picted the foci in 31, 31, and 28, cases, respectively. Among 11 benig n lesions, nine showed no increased FDG uptake (specificity = 82%). Sp ecificities of the other modalities were lower. False-positive finding s were obtained in a case of chronic active pancreatitis and in a sero us cystadenoma. CONCLUSION: FDG PET, which provides ''biochemical'' in formation, is accurate in identifying pancreatic carcinoma and may be a method of choice when imaging equivocal masses detected with other ' 'anatomic'' imaging studies.