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PET and PET/CT Imaging in Tumors of the Pancreas and Liver

  • Chapter
Positron Emission Tomography

Summary

FDG-PET imaging appears helpful in differentiating malignant from benign hepatic lesions, with the exception of false-negative HCC, false-negative infiltrating cholangiocarcinoma, and false-positive inflammatory lesions. It is not helpful to identify HCC in patients with cirrhosis and regenerating nodules. In patients with primary malignant hepatic tumors that accumulate FDG, PET imaging does identify unexpected distant metastases (although miliary carcinomatosis is often false negative) and can help in monitoring response to therapy. FDG-PET imaging seems promising for monitoring patient response to therapy, including regional therapy to the liver, but larger studies are necessary.

FDG-PET imaging is especially helpful for the preoperative diagnosis of pancreatic carcinoma in patients with suspected pancreatic cancer in whom CT fails to identify a discrete tumor mass or in whom biopsy is nondiagnostic. By providing scintigraphic preoperative documentation of pancreatic malignancy in these patients, laparotomy may be undertaken with a curative intent, and the risk of aborting resection because of diagnostic uncertainty is minimized. FDG-PET imaging is also useful for M staging and restaging by detecting CT-occult metastatic disease and allowing nontherapeutic resection to be avoided altogether in this group of patients. As is true with other neoplasms, FDG-PET can accurately differentiate posttherapy changes from recurrence and holds promise for monitoring neoadjuvant chemoradiation therapy.

FDG-PET imaging is complementary to morphologic imaging with CT; therefore, integrated PET/CT imaging provides optimal images for interpretation.

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Authors and Affiliations

  1. Positron Emission Tomography, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA

    Dominique Delbeke MD, PhD (Professor and Director of Nuclear Medicine)

  2. Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA

    William H. Martin MD

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  1. Dominique Delbeke MD, PhD
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Editor information

Editors and Affiliations

  1. Northern California PET Imaging Center, Sacramento, CA, USA

    Peter E. Valk MB, BS, FRACP

  2. Positron Emission Tomography, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA

    Dominique Delbeke MD, PhD (Professor and Director of Nuclear Medicine) (Professor and Director of Nuclear Medicine)

  3. Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, Australia

    Dale L. Bailey PhD (Associate Professor of Medicine) (Associate Professor of Medicine)

  4. Cancer Imaging and Tracer Development Program, The University of Tennessee Medical Center, Knoxville, TN, USA

    David W. Townsend PhD (Director) (Director)

  5. Department of Radiological Sciences, Guy’s and St Thomas’ Clinical PET Centre, Guy’s and St Thomas’ Hospital Trust, London, UK

    Michael N. Maisey BSc, MD, FRCR, FRCP (Professor of Emeritus) (Professor of Emeritus)

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Delbeke, D., Martin, W.H. (2006). PET and PET/CT Imaging in Tumors of the Pancreas and Liver. In: Valk, P.E., Delbeke, D., Bailey, D.L., Townsend, D.W., Maisey, M.N. (eds) Positron Emission Tomography. Springer, London . https://doi.org/10.1007/1-84628-187-3_12

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