THE ROLE OF FLUORODEOXYGLUCOSE AND POSITRON-EMISSION-TOMOGRAPHY IN THE EVALUATION OF PANCREATIC DISEASE

Background. The difficulties involved in the timely and accurate diagn osis of pancreatic disease are well known. The usual imaging modalitie s usually identify abnormalities But may not always differentiate mali gnancy from other condition such as scar tissue or chronic inflammatio n. The purpose Of our study was to determine if fluorodeoxyglucose pos itron emission tomography (FDG PET) can accurately diagnose pancreatic disease. Methods. The records of 15 patients presenting with pancreat ic disease were retrospectively reviewed. The diagnosis suspected by i maging modalities was compared with the final tissue diagnosis. Two pa tients were excluded because no tissue was obtained. Results. Adenocar cinoma was diagnosed in 9 patients. A mass consistent with this diagno sis was seen in 8 of 9, 6 of 9, 6 of 8, and 5 of 5 patients by PET com puted to tomography (CT), endoscopic retrograde cholangiopancreatograp hy (ERCP), and endoscopic ultrasound (EUS), respectively. Chronic panc reatitis (CP) was diagnosed in 2 patients. The unique appearance on FD G PET made the diagnosis in both these patients. Both patients with CL P were thought to have a malignancy by CT and EUS and 2 of 2 by ERCP. Neuroendocrine tumors were diagnosed in 2 other patients. One of 2 was seen by FDG PET and both by CT. Conclusions. FDG PET can accurately d ifferentiate a pancreatic adenocarcinoma from chronic pancreatitis in a patient with a suspicious pancreatic mass. Thus, FDG PET may help in establishing a diagnosis and subsequently managing a patient with pan creatic disease.