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Is 18F-fluorodeoxyglucose positron emission tomography meaningful for estimating the efficacy of corticosteroid therapy in patients with autoimmune pancreatitis?

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Journal of Hepato-Biliary-Pancreatic Sciences



Autoimmune pancreatitis (AIP) is often misdiagnosed as pancreatic cancer (PC). Both conditions accumulate 18F-fluorodeoxyglucose (FDG), so FDG positron emission tomography (FDG-PET) is not discriminatory. This study aimed to evaluate the pattern of FDG accumulation, and the change in FDG uptake after steroid treatment in AIP and PC.


We compared FDG-PET patterns between 18 patients with AIP and 20 patients with PC, and also evaluated the short-term changes in FDG uptake after steroid therapy.


FDG uptake was observed in 88.9% in AIP and 90.0% in PC. FDG uptake in extra-abdominal lymph nodes was seen more frequently in AIP, and uptake in salivary glands, eyes and biliary ducts was seen only in AIP. Follow-up PET was performed in 6 AIP patients and in 3 PC patients. Changes in SUVmax after steroid therapy were estimated within 1 week in 5 AIP patients and in all 3 PC patients, retrospectively. In 4 AIP patients, the change in SUVmax was more than 10%. On the other hand, in PC, SUVmax increased or remained almost unchanged (within 10%).


FDG-PET pattern at baseline, and a decrease in FDG uptake after a short steroid trial can be useful for discriminating AIP from PC.

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The authors thank Dr Yuji Nimura, president of Aichi Cancer Center for looking over our manuscript. This work was supported by the grants from the Ministry of Health, Labor and Welfare (to NM and KY).

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Correspondence to Minoru Shigekawa.

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Shigekawa, M., Yamao, K., Sawaki, A. et al. Is 18F-fluorodeoxyglucose positron emission tomography meaningful for estimating the efficacy of corticosteroid therapy in patients with autoimmune pancreatitis?. J Hepatobiliary Pancreat Sci 17, 269–274 (2010).

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