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Integrated FDG-PET/CT contribution over cross-sectional imaging in recurrence or progression of pancreaticobiliary neoplasms

  • Pancreas
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Abstract

Purpose

We aim to compare FDG-PET/CT and cross-sectional imaging (contrastenhanced CT/MRI) diagnostic abilities in detecting recurrence/progression of pancreaticobiliary system tumors and to reveal the clinical impact of integrated FDGPET/CT to CT/MRI on patient management.

Materials and Methods

FDG-PET/CT and CT/MRI scans of 70 patients from initiation of treatment until proven recurrence/progression were retrospectively evaluated. FDGPET/CT and contrast-enhanced CT/MRI accuracy, sensitivity, specificity, PPV and NPV are compared in terms of overall recurrence/progression diagnosis and sitespecific concern; local disease, local lymph node, and distant organ metastasis. The impact of integrated FDG-PET/CT on patient management is scrutinized.

Results

CT/MRI has higher sensitivity than FDG-PET/CT in detecting loco-regional involvement (90% vs 76.7% P: 0.152), local lymph node metastasis (88.9% vs 77.8%, P: 0.380) and distant organ metastasis (96.5% vs 80.7%; P: 0.006) in tumor recurrence/progression. In overall diagnosis, CT/MRI is more sensitive and accurate but less specific than FDG-PET/CT (92.3% vs 87.7%; 87.1% vs 84.2%; 40% vs 20%, respectively). In 8% (6/70) of patients FDG-PET/CT had a major impact on patient management.

Conclusion

FDG-PET/CT and cross-sectional imaging have different advantages and shortcomings. In recurrence/progression, recognition of early changes is more feasible by CT/MRI. However, inconsistency of morphologic and metabolic findings is important reason of cross-sectional imaging failure. FDG-PET/CT is superior in showing extraabdominal metastases, but missing small-volume lesions and misinterpreting inflammatory changes are still a problem lowering its sensitivity. Nevertheless FDGPET/CT is good option for guiding undetermined imaging findings or clinic-radiologic mismatch.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, İstanbul Medipol University Hospital, İstanbul, Turkey

    Banu Karaalioglu & Mehmet Seker

  2. Department of Nuclear Medicine, İstanbul Medipol University Hospital, İstanbul, Turkey

    Tansel Cakir

  3. Department of Clinical Oncology, İstanbul Medipol University Hospital, İstanbul, Turkey

    Yasin Kutlu & Ahmet Bilici

Authors
  1. Banu Karaalioglu
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  2. Tansel Cakir
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  3. Yasin Kutlu
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  4. Mehmet Seker
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  5. Ahmet Bilici
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Correspondence to Banu Karaalioglu.

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Karaalioglu, B., Cakir, T., Kutlu, Y. et al. Integrated FDG-PET/CT contribution over cross-sectional imaging in recurrence or progression of pancreaticobiliary neoplasms. Abdom Radiol 49, 131–140 (2024). https://doi.org/10.1007/s00261-023-04109-3

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  • DOI: https://doi.org/10.1007/s00261-023-04109-3

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