Skip to main content
SpringerLink
Log in

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

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background

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.

Methods

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.

Results

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%).

Conclusions

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

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Yoshida K, Toki F, Takeuchi T, Watanabe S, Shiratori K, Hayashi N. Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis. Dig Dis Sci. 1995;40:1561–8.

    Article  CAS  PubMed  Google Scholar 

  2. Okazaki K, Uchida K, Fukui T. Recent advances in autoimmune pancreatitis: concept, diagnosis, and pathogenesis. J Gastroenterol. 2008;43:409–18.

    Article  CAS  PubMed  Google Scholar 

  3. Kamisawa T, Okamoto A. Autoimmune pancreatitis: proposal of IgG4-related sclerosing disease. J Gastroenterol. 2006;41:613–25.

    Article  CAS  PubMed  Google Scholar 

  4. Ito T, Nakano I, Koyanagi S, Miyahara T, Migita Y, Ogoshi K, et al. Autoimmune pancreatitis as a new clinical entity. Three cases of autoimmune pancreatitis with effective steroid therapy. Dig Dis Sci. 1997;42:1458–68.

    Article  CAS  PubMed  Google Scholar 

  5. Members of the Criteria Committee for Autoimmune Pancreatitis of the Japan Pancreas Society. Diagnostic criteria for autoimmune pancreatitis by the Japan Pancreas Society (in Japanese). J Jpn Pancreas society (Suizou) 2002;17:587.

    Google Scholar 

  6. Okazaki K, Kawa S, Kamisawa T, Naruse S, Tanaka S, Nishimori I, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006;41:626–31.

    Article  PubMed  Google Scholar 

  7. Chari ST, Smyrk TC, Levy MJ, Topazian MD, Takahashi N, Zhang L, et al. Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience. Clin Gastroenterol Hepatol. 2006;4:1010–6.

    Article  PubMed  Google Scholar 

  8. Kim MH, Kwon S. Diagnostic criteria for autoimmune chronic pancreatitis. J Gastroenterol. 2007;42(Suppl 18):42–9.

    Article  PubMed  Google Scholar 

  9. Delbeke D, Rose DM, Chapman WC, Pinson CW, Wright JK, Beauchamp RD, et al. Optimal interpretation of FDG PET in the diagnosis, staging and management of pancreatic carcinoma. J Nucl Med. 1999;40:1784–91.

    CAS  PubMed  Google Scholar 

  10. Imdahl A, Nitzsche E, Krautmann F, Högerle S, Boos S, Einert A, et al. Evaluation of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose for the differentiation of chronic pancreatitis and pancreatic cancer. Br J Surg. 1999;86:194–9.

    Article  CAS  PubMed  Google Scholar 

  11. Higashi T, Saga T, Nakamoto Y, Ishimori T, Fujimoto K, Doi R, et al. Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET)–usefulness and limitations in “clinical reality”. Ann Nucl Med. 2003;17:261–79.

    Article  PubMed  Google Scholar 

  12. Nakamoto Y, Saga T, Ishimori T, Higashi T, Mamede M, Okazaki K, et al. FDG-PET of autoimmune-related pancreatitis: preliminary results. Eur J Nucl Med. 2000;27:1835–8.

    Article  CAS  PubMed  Google Scholar 

  13. Nakajo M, Jinnouchi S, Fukukura Y, Tanabe H, Tateno R, Nakajo M. The efficacy of whole-body FDG-PET or PET/CT for autoimmune pancreatitis and associated extrapancreatic autoimmune lesions. Eur J Nucl Med Mol Imaging. 2007;34:2088–95.

    Article  PubMed  Google Scholar 

  14. Salvarani C, Pipitone N, Versari A, Vaglio A, Serafini D, Bajocchi G, et al. Positron emission tomography (PET): evaluation of chronic periaortitis. Arthritis Rheum. 2005;53:298–303.

    Article  PubMed  Google Scholar 

  15. Ozaki Y, Oguchi K, Hamano H, Arakura N, Muraki T, Kiyosawa K, et al. Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography. J Gastroenterol. 2008;43:144–51.

    Article  CAS  PubMed  Google Scholar 

  16. Bares R, Klever P, Hauptmann S, Hellwig D, Fass J, Cremerius U, et al. F-18 fluorodeoxyglucose PET in vivo evaluation of pancreatic glucose metabolism for detection of pancreatic cancer. Radiology. 1994;192:79–86.

    CAS  PubMed  Google Scholar 

  17. Huang SC. Anatomy of SUV Standard uptake value. Nucl Med Biol. 2000;27:643–6.

    Article  CAS  PubMed  Google Scholar 

  18. Koyama K, Okamura T, Kawabe J, Nakata B, Chung KH, Ochi H, et al. Diagnostic usefulness of FDG PET for pancreatic mass lesions. Ann Nucl Med. 2001;15:217–24.

    Article  CAS  PubMed  Google Scholar 

  19. Nakamoto Y, Sakahara H, Higashi T, Saga T, Sato N, Okazaki K, et al. Autoimmune pancreatitis with F-18 fluoro-2-deoxy-d-glucose PET findings. Clin Nucl Med. 1999;24:778–80.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

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).

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan

    Minoru Shigekawa, Kenji Yamao, Akira Sawaki, Kazuo Hara, Tadayuki Takagi & Nobumasa Mizuno

  2. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan

    Minoru Shigekawa

  3. Department of Medical Hepatology, Institute of Liver and Biliary Sciences (ILBS), Delhi, India

    Vikram Bhatia

  4. Nagoya PET Imaging Center, Nagoya, Japan

    Masami Nishio

  5. East Nagoya Imaging Diagnosis Center, Nagoya, Japan

    Tsuneo Tamaki

  6. Department of Internal Medicine, Gastroenterology Unit, Assiut University, Assiut, Egypt

    Hussein El-Amin & Zain EL-Abdeen Ahmed Sayed

Authors
  1. Minoru Shigekawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenji Yamao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akira Sawaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazuo Hara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tadayuki Takagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vikram Bhatia
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masami Nishio
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tsuneo Tamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hussein El-Amin
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Zain EL-Abdeen Ahmed Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Nobumasa Mizuno
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Minoru Shigekawa.

About this article

Cite this article

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). https://doi.org/10.1007/s00534-009-0172-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-009-0172-9

Keywords

Search

Navigation