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F-18-fluorodeoxyglucose positron emission tomography in differentiating malignant from benign pancreatic cysts: A prospective study

  • Published:
Journal of Gastrointestinal Surgery

Abstract

The differential diagnosis between benign and malignant pancreatic cystic lesions may be very difficult. We recently found that F-18-.uorodeoxyglucose positron emission tomography (18-FDG PET) was useful for the preoperative work-up of pancreatic cystic lesions. This study was undertaken to confirm these results. From February 2000 to July 2003, 50 patients with a pancreatic cystic lesion were prospectively investigated with 18-FDG PET in addition to helical computed tomography (CT) and, in some instances, magnetic resonance imaging (MRI). The validation of diagnosis was based on pathologic findings after surgery (n = 31), percutaneous biopsy (n = 4), and according to follow-up in 15 patients. The 18-FDG PET was analyzed visually and semiquantitatively using the standard uptake value (SUV). The accuracy of FDG PET and CT was determined for preoperative diagnosis of malignant cystic lesions. Seventeen patients had malignant cystic lesions. Sixteen (94%) showed increased 18-FDG uptake (SUV >2.5), including two patients with carcinoma in situ. Eleven patients (65%) were correctly identified as having malignancy by CT. Thirty-three patients had benign tumors: two patients showed increased 18-FDG uptake, and four patients showed CT findings of malignancy. Sensitivity, specificity, positive and negative predictive value, and accuracy of 18-FDG PET and CT in detecting malignant tumors were 94%, 94%, 89%, 97%, and 94% and 65%, 88%, 73%, 83%, and 80%, respectively. 18-FDG PET is accurate in identifying malignant pancreatic cystic lesions and should be used in combination with CT in the preoperative evaluation of patients with pancreatic cystic lesions. A negative result with 18-FDG PET may avoid unnecessary operation in asymptomatic or high-risk patients.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Padua, Padova, Italy

    Cosimo Sperti M.D., Claudio Pasquali M.D., Giandomenico Decet M.D. & Sergio Pedrazzoli M.D., F.A.C.S.

  2. Department of Nuclear Medicine, Castelfranco Hospital, Castelfranco Veneto, Treviso, Italy

    Franca Chierichetti M.D.

  3. Department of Radiology, Castelfranco Hospital, Castelfranco Veneto, Treviso, Italy

    Guido Liessi M.D.

Authors
  1. Cosimo Sperti M.D.
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  2. Claudio Pasquali M.D.
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  3. Giandomenico Decet M.D.
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  4. Franca Chierichetti M.D.
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  5. Guido Liessi M.D.
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  6. Sergio Pedrazzoli M.D., F.A.C.S.
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Corresponding author

Correspondence to Sergio Pedrazzoli M.D., F.A.C.S..

Additional information

This study was supported by the Ministero Università e Ricerca Scientifica (Cofin 2001068593-001), Rome, Italy.

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Sperti, C., Pasquali, C., Decet, G. et al. F-18-fluorodeoxyglucose positron emission tomography in differentiating malignant from benign pancreatic cysts: A prospective study. J Gastrointest Surg 9, 22–29 (2005). https://doi.org/10.1016/j.gassur.2004.10.002

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