scholarly journals Pretherapeutic Assessment of Pancreatic Cancer: Comparison of FDG PET/CT Plus Delayed PET/MR and Contrast-Enhanced CT/MR

2022 ◽  
Vol 11 ◽  
Author(s):  
Zaizhu Zhang ◽  
Nina Zhou ◽  
Xiaoyi Guo ◽  
Nan Li ◽  
Hua Zhu ◽  
...  

PurposeThis study aims to determine the diagnostic performance of whole-body FDG PET/CT plus delayed abdomen PET/MR imaging in the pretherapeutic assessment of pancreatic cancer in comparison with that of contrast-enhanced (CE)-CT/MR imaging.Materials and MethodsForty patients with pancreatic cancer underwent nonenhanced whole-body FDG PET/CT, delayed abdomen PET/MR imaging, and CE-CT/MR imaging. Two nuclear medicine physicians independently reviewed these images and discussed to reach a consensus, determining tumor resectability according to a 5-point scale, N stage (N0 or N positive), and M stage (M0 or M1). With use of clinical-surgical-pathologic findings as the reference standard, diagnostic performances of the two imaging sets were compared by using the McNemar test.ResultsThe diagnostic performance of FDG PET/CT plus delayed PET/MR imaging was not significantly different from that of CE-CT/MR imaging in the assessment of tumor resectability [area under the receiver operating characteristic curve: 0.927 vs. 0.925 (p = 0.975)], N stage (accuracy: 80% (16 of 20 patients) vs. 55% (11 of 20 patients), p = 0.125), and M stage (accuracy: 100% (40 of 40 patients) vs. 93% (37 of 40 patients), p = 0.250). Moreover, 14 of 40 patients had liver metastases. The number of liver metastases detected by CE-CT/MR imaging, PET/CT, and PET/MR imaging were 33, 18, and 61, respectively. Compared with CE-CT/MR imaging, PET/MR imaging resulted in additional findings of more liver metastases in 9/14 patients, of which 3 patients were upstaged. Compared with PET/CT, PET/MR imaging resulted in additional findings of more liver metastases in 12/14 patients, of which 6 patients were upstaged.ConclusionsAlthough FDG PET/CT plus delayed PET/MR imaging showed a diagnostic performance similar to that of CE-CT/MR imaging in the pretherapeutic assessment of the resectability and staging of pancreatic tumors, it still has potential as the more efficient and reasonable work-up approach for the additional value of metastatic information provided by delayed PET/MR imaging.

Pancreas ◽  
2013 ◽  
Vol 42 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Akinori Asagi ◽  
Koji Ohta ◽  
Junichirou Nasu ◽  
Minoru Tanada ◽  
Seijin Nadano ◽  
...  

Author(s):  
Olwen Westerland ◽  
◽  
Ashik Amlani ◽  
Christian Kelly-Morland ◽  
Michal Fraczek ◽  
...  

Abstract Purpose Comparative data on the impact of imaging on management is lacking for multiple myeloma. This study compared the diagnostic performance and impact on management of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and whole-body magnetic resonance imaging (WBMRI) in treatment-naive myeloma. Methods Forty-six patients undergoing 18F-FDG PET/CT and WBMRI were reviewed by a nuclear medicine physician and radiologist, respectively, for the presence of myeloma bone disease. Blinded clinical and imaging data were reviewed by two haematologists in consensus and management recorded following clinical data ± 18F-FDG PET/CT or WBMRI. Bone disease was defined using International Myeloma Working Group (IMWG) criteria and a clinical reference standard. Per-patient sensitivity for lesion detection was established. McNemar test compared management based on clinical assessment ± 18F-FDG PET/CT or WBMRI. Results Sensitivity for bone lesions was 69.6% (32/46) for 18F-FDG PET/CT (54.3% (25/46) for PET component alone) and 91.3% (42/46) for WBMRI. 27/46 (58.7%) of cases were concordant. In 19/46 patients (41.3%) WBMRI detected more focal bone lesions than 18F-FDG PET/CT. Based on clinical data alone, 32/46 (69.6%) patients would have been treated. Addition of 18F-FDG PET/CT to clinical data increased this to 40/46 (87.0%) patients (p = 0.02); and WBMRI to clinical data to 43/46 (93.5%) patients (p = 0.002). The difference in treatment decisions was not statistically significant between 18F-FDG PET/CT and WBMRI (p = 0.08). Conclusion Compared to 18F-FDG PET/CT, WBMRI had a higher per patient sensitivity for bone disease. However, treatment decisions were not statistically different and either modality would be appropriate in initial staging, depending on local availability and expertise.


HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S345-S346
Author(s):  
N. Russolillo ◽  
A. Borello ◽  
S. Langella ◽  
R. Lo Tesoriere ◽  
F. Forchino ◽  
...  

2008 ◽  
Vol 49 (9) ◽  
pp. 1408-1413 ◽  
Author(s):  
K. Strobel ◽  
S. Heinrich ◽  
U. Bhure ◽  
J. Soyka ◽  
P. Veit-Haibach ◽  
...  

2020 ◽  
Author(s):  
Shengyun Huang ◽  
Huanhuan Chong ◽  
Xun Sun ◽  
Zhijian Wu ◽  
Qing Jia ◽  
...  

Abstract Background: Pancreatic cancer is one of the most fatal tumors in the world, which incidence and mortality have continued to rise in the past decade. The main challenge in clinical practice for patients with pancreatic cancer is to accurately distinguish malignant lesions from benign ones in early evaluation. This research aims to investigate the value of 18F-FDG PET/CT in diagnosing pancreatic lesions, and compare it with CA19-9, contrast-enhanced CT (CECT), and contrast-enhanced MRI (CEMR).Methods: Cases of patients with suspected pancreatic lesions examined between Jan 1st, 2011 and June 30th, 2017 were retrospectively analyzed. CA19-9, CECT and CEMR within 2 weeks of PET/CT were evaluated. We compared the diagnostic efficacy of PET/CT with CA19-9, CECT and CEMR as well as combined tests.Results: A total of 467 cases were examined in this study, including 293 males and 174 females, with an average age of 57.79 ± 12.68 y (16–95 y). Cases in the malignant group (n=248) had significantly higher SUVmax (7.34 ± 4.17 vs. 1.70 ± 2.68, P < 0.001) and CA19-9 (663.21 ± 531.98 vs. 87.80 ± 218.47, P < 0.001) than those in the benign group (n=219). The sensitivity, specificity and accuracy of PET/CT were 91.9%, 96.3% and 94.0% respectively. Those for CECT were 83.6%, 77.8%, 81.2% respectively; and 91.2%, 75.0%, 81.7% were for CEMR. PET/CT corrected 14.7% (28/191) CECT diagnoses and 12.2% (10/82) CEMR diagnoses. Although the diagnostic efficiency of CA19-9 was acceptable (80.0%, 69.0%, 74.9% respectively), the joint application of PET/CT and CA19-9 could significantly enhance the diagnostic efficiency compared with PET/CT alone (sen 97.4% vs. 90.5%, P =0.0003; spe 100.0% vs. 95.2%, P = 0.0047). Conclusions: PET/CT has sensitivity similar to CECT, CEMR and significantly higher specificity and accuracy, helping reduce false diagnoses of morphological images. Combining PET/CT with CA19-9 could enhance diagnostic efficiency.


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