The value of 18F-FDG positron emission tomography/computed tomography on the pre-operative staging and the management of patients with pancreatic carcinoma

Abstract

Background/aims: To evaluate the value of FDG-PET/CT on the pre-operative staging of pancreatic cancer and its impact on clinical management.

Methodology: From December 2006 to January 2013, data of pancreatic carcinoma patients who underwent surgical treatment at our center was collected retrospectively. MDCT and FDGPET/CT were used separately to diagnose and stage the tumor. Pre-operation staging by MDCT with chest x-ray and by FDG-PET/CT was compared according to the final pathological staging.

Results: A total of 79 histologically proven pancreatic cancer patients were enrolled in this study. FDG-PET/CT was more accurate in the detection of tumor (PET/CT vs. MDCT: 93.67% vs. 88.61%, p=0.402). The SE (60.00% vs. 24.00%, p=0.01) and accuracy (87.81% vs. 76.83%, p=0.015) of PET/CT to detect distant metastasis is significantly higher than those of MDCT. FDG-PET/CT also showed advantage over CT in the detection of metastatic lymph nodes (52.83% vs. 16.98%, p<0.001; accuracy: 66.67% vs. 41.33, p=0.002). The extra staging information PET/CT provided could have skipped eight patients (10.13%) of unnecessary surgical exploration.

Conclusion: FDG-PET/CT is an important staging procedure and helps to make the clinical decision for the patients with pancreatic carcinoma.