| Autor: |
Schick, Verena, Franzius, Christiane, Beyna, Torsten, May Lin Oei, Schnekenburger, Jürgen, Weckesser, Matthias, Domschke, Wolfram, Schober, Otmar, Heindel, Walter, Pohle, Thorsten, Juergens, Kai Uwe |
| Předmět: |
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| Zdroj: |
European Journal of Nuclear Medicine & Molecular Imaging; Oct2008, Vol. 35 Issue 10, p1775-1785, 11p, 3 Color Photographs, 3 Black and White Photographs, 4 Charts |
| Abstrakt: |
This prospective single-centre phase II trial assessed the diagnostic impact of 18F-FDG PET–CT in the evaluation of solid pancreatic lesions (∅ ≥10 mm) compared to endosonography (EUS), endoscopic retrograde cholangio-pancreatography (ERCP) with intraductal ultrasound (IDUS), abdominal ultrasound (US) and histopathological reference. Forty-six patients (32 men/14 women, ∅ 61.7 years) with suspected pancreatic neoplasms underwent PET–CT with contrast-enhanced biphasic multi-detector CT of the upper abdomen followed by a diagnostic work-up with EUS, ERCP with IDUS and US within 3 weeks. PET–CT data sets were analysed by two expert readers in a consensus reading. Histology from surgery, biopsy/fine-needle aspiration and/or clinical follow-up ≥12 months served as standard of reference. Twenty-seven pancreatic malignancies were histopathologically proven; 19 patients had benign diseases: 36/46 lesions (78%) were detected in the head of the pancreas, 7/46 and 3/46 in the body and tail region, respectively. Sensitivity and specificity of PET–CT were 89% and 74%, respectively; positive predictive value (PPV) and negative predictive value (NPV) were 83% and 82%, respectively. Sensitivity (81–89%), specificity (74–88%), PPV (83–90%) and NPV (77–82%) achieved by EUS, ERCP and US were not significantly different. PET analysis revealed significantly higher maximum mean standardised uptake values (SUVmax 6.5 ± 4.6) in patients with pancreatic malignancy (benign lesions: SUVmax 4.2 ± 1.5; p < 0.05). PET–CT revealed cervical lymphonodal metastasis from occult bronchogenic carcinoma and a tubular colon adenoma with intermediate dysplasia on polypectomy, respectively. 18F-FDG PET–CT achieves a comparably high diagnostic impact evaluating small solid pancreatic lesions versus conventional reference imaging modalities. Additional clinical diagnoses are derived from concomitant whole-body PET–CT imaging. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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