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The efficacy of whole-body FDG-PET or PET/CT for autoimmune pancreatitis and associated extrapancreatic autoimmune lesions

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Abstract

Purpose

The aim of this study was to evaluate retrospectively the efficacy of whole-body 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for autoimmune pancreatitis (AIP) and associated extrapancreatic autoimmune lesions.

Methods

Whole-body FDG-PET or PET/computed tomography (CT) findings were reviewed in six patients with AIP. The initial PET scans were performed 1 h and 2 h after FDG injection in all six patients. Follow-up PET scans were performed during or following steroid therapy in five patients and in one patient who did not have steroid therapy.

Results

The initial PET scans revealed intense FDG uptake by AIP in all six patients. The maximum standardized uptake value (SUVmax) increased in four patients and was stable in two patients. The intense uptake in the pancreas disappeared during or following steroid therapy in five patients and in one patient who showed spontaneous remission of AIP. Abnormal FDG uptake by extrapancreatic autoimmune diseases was observed in five of the six patients: sclerosing sialadenitis (n = 5), lymphadenopathy (n = 5), retroperitoneal fibrosis (n = 2), interstitial nephritis (n = 2) and sclerosing cholecystitis (n = 1). Abnormal FDG uptake disappeared in the salivary glands (n = 4), lymph nodes (n = 4), retroperitoneum (n = 2), kidneys (n = 1) and gallbladder (n = 1) during or following steroid therapy and remained in the salivary glands and lymph nodes of a spontaneous remission patient.

Conclusion

These results suggest that whole-body FDG-PET may be useful for detecting AIP and associated extrapancreatic autoimmune lesions and for monitoring their disease activity but that dual time point imaging may not be useful for differentiating malignancy from AIP.

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Acknowledgements

The authors thank Dr. Hideaki Uozumi (Uozumi Clinic) for providing us the follow-up data of Patient 2.

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Authors and Affiliations

  1. Department of Radiology, Atsuchi Memorial Clinic PET Center, 12-1 Terukuni, Kagoshima City, 892-0841, Japan

    Masatoyo Nakajo, Seishi Jinnouchi & Rie Tateno

  2. Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Masatoyo Nakajo, Yoshihiko Fukukura, Hiroaki Tanabe & Masayuki Nakajo

Authors
  1. Masatoyo Nakajo
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  2. Seishi Jinnouchi
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  3. Yoshihiko Fukukura
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  4. Hiroaki Tanabe
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  5. Rie Tateno
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  6. Masayuki Nakajo
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Correspondence to Masatoyo Nakajo.

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Nakajo, M., Jinnouchi, S., Fukukura, Y. et al. The efficacy of whole-body FDG-PET or PET/CT for autoimmune pancreatitis and associated extrapancreatic autoimmune lesions. Eur J Nucl Med Mol Imaging 34, 2088–2095 (2007). https://doi.org/10.1007/s00259-007-0562-7

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  • DOI: https://doi.org/10.1007/s00259-007-0562-7

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