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. 2016 Sep 29:11:1365-1370.
doi: 10.2147/CIA.S115254. eCollection 2016.

Application of 18F-FDG PET/CT combined with carbohydrate antigen 19-9 for differentiating pancreatic carcinoma from chronic mass-forming pancreatitis in Chinese elderly

Xinjin Gu  1 , Rong Liu  2
Affiliations

Application of 18F-FDG PET/CT combined with carbohydrate antigen 19-9 for differentiating pancreatic carcinoma from chronic mass-forming pancreatitis in Chinese elderly

Xinjin Gu et al. Clin Interv Aging. .

Abstract

Objective: The current study was designed to analyze the value of 18F-FDG positron emission tomography/computed tomography (PET/CT) combined with carbohydrate antigen 19-9 (CA19-9) in differentiating pancreatic carcinoma (PC) from chronic mass-forming pancreatitis (CMFP) in Chinese elderly.

Methods: As it is impossible to differentially diagnose PC from CMFP, 60 participants older than 65 years with focal pancreatic lesions were scanned by 18F-FDG PET/CT and their CA19-9 levels were tested. Diagnoses of all participants were confirmed by comprehensive methods including aspiration biopsy, surgical pathology, and clinical follow-up of 12 months. Twenty participants with CMFP were included in CMFP group and 40 participants with PC in PC group.

Results: In CMFP and PC groups, 46 participants showed increased 18F-FDG uptake, 43 had elevated CA19-9 levels, and 38 participants had both increased 18F-FDG uptake and elevated CA19-9 levels. Standardized uptake value maximum of PC group (5.98±2.27) was significantly different from CMFP group (2.58±1.81, P<0.05). Sensitivity, specificity, and accuracy of 18F-FDG PET/CT in differentiating PC from CMFP were 95%, 60%, and 83.3%, respectively. CA19-9 levels of PC group (917.44±1,088.24) were significantly different from CMFP group (19.09±19.54, P<0.05). Sensitivity, specificity, and accuracy of CA19-9 levels in differentiating PC from CMFP were 87.5%, 60%, and 78.3%, respectively. Sensitivity, specificity, and accuracy of 18F-FDG PET/CT combined with CA19-9 levels in differentiating PC from CMFP were 90%, 90%, and 90%, respectively.

Conclusion: 18F-FDG PET/CT had reliable sensitivity, specificity, and accuracy in differentiating PC from CMFP, and CA19-9 levels could be helpful in 18F-FDG PET/CT for differentiating PC from CMFP in Chinese elderly. Moreover, 18F-FDG PET/CT combined with CA19-9 levels was found to be an effective method to differentially diagnose PC from CMFP and has paved the way for the timely and safe treatment of PC and CMFP in Chinese elderly.

Keywords: 18F-FDG PET/CT; Chinese elderly; carbohydrate antigen 19-9; chronic mass-forming pancreatitis; pancreatic carcinoma.

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Figures

Figure 1
Figure 1
Images of a male participant, 69 years. Notes: Computed tomography showed that there was a suspicious lesion in his pancreas. His carbohydrate antigen 19-9 level was 51.68. 18F-FDG PET/CT showed that there was no lesion with increased 18F-FDG uptake in his pancreas. Finally, he was diagnosed with chronic mass-forming pancreatitis. (A) Pancreatic head lesion in computed tomography; (B) pancreatic head lesion in 18F-FDG PET/CT; (C) pancreatic duct dilatation in computed tomography; and (D) pancreatic duct dilatation in 18F-FDG PET/CT. Abbreviations: PET, positron emission tomography; CT, computed tomography.
Figure 2
Figure 2
Images of a female participant, 66 years. Notes: Computed tomography showed that there was a suspicious lesion in her pancreas. Her carbohydrate antigen 19-9 level was 1015. 18F-FDG PET/CT showed that there was a lesion with increased 18F-FDG uptake (standardized uptake value maximum =6.34) in her pancreas. Finally, she was diagnosed with pancreatic carcinoma. (A) Coronal view of images obtained by 18F-FDG PET; (B) horizontal view of images obtained by 18F-FDG PET; (C) horizontal view of images obtained by CT; (D) and horizontal view of images obtained by 18F-FDG PET/CT. Abbreviations: PET, positron emission tomography; CT, computed tomography.
Figure 3
Figure 3
Scatter plot for participants with chronic mass-forming pancreatitis between standardized uptake value maximum and carbohydrate antigen 19-9 levels.
Figure 4
Figure 4
Scatter plot for participants with pancreatic carcinoma between standardized uptake value maximum and carbohydrate antigen 19-9 levels.
See this image and copyright information in PMC

References

    1. Maisonneuve P, Lowenfels AB. Epidemiology of pancreatic cancer: an update. Dig Dis. 2010;28(4–5):645–656. - PubMed
    1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10–29. - PubMed
    1. Spanier BW, Dijkgraaf MG, Bruno MJ. Epidemiology, aetiology and outcome of acute and chronic pancreatitis: an update. Best Prac Res Clin Gastroenterol. 2008;22(1):45–63. - PubMed
    1. Tajima Y, Kuroki T, Tsutsumi R, Isomoto I, Uetani M, Kanematsu T. Pancreatic carcinoma coexisting with chronic pancreatitis versus tumor-forming pancreatitis: diagnostic utility of the time-signal intensity curve from dynamic contrast-enhanced MR imaging. World J Gastroenterol. 2007;13(6):858–865. - PMC - PubMed
    1. Martina MC, Cassinis MC, Tappero C, Gandini G. Non invasive methods in competition for EUS (US, CE-US, CT, MRI and PET/CT): the radiologist point of view. Minerva Med. 2007;98(4):343–350. - PubMed

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