Clinical utility of positron emission tomography in the diagnosis and management of periampullary neoplasms.

Journal Article (Journal Article)

BACKGROUND: This study examined the effect that 18-fluorodeoxyglucose positron emission tomography ((18)FDG-PET) imaging had on the clinical management of patients with suspected periampullary malignancy. METHODS: Fifty-four patients with suspected pancreatic neoplasms underwent both whole-body (18)FDG-PET and abdominal computed tomography (CT). Malignant or benign disease was confirmed pathologically in 47 patients. RESULTS: Of the 41 patients with malignancy, (18)FDG-PET failed to identify the primary tumor in 5 patients. (18)FDG-PET demonstrated increased uptake suggesting primary malignancy in 37 patients. Malignant pathology was confirmed in 36 cases. (18)FDG-PET identified malignant locoregional lymph node metastases in six of ten patients. All nodes identified before surgery by (18)FDG-PET were also seen on preoperative CT. Six patients who were thought to have resectable disease by CT were found to have distant metastasis at laparotomy. (18)FDG-PET did not detect metastasis in any of these cases. Before surgery, (18)FDG-PET identified distant metastases that were not detected by CT in one patient. CONCLUSIONS: Despite high sensitivity and specificity in diagnosing periampullary malignancy, (18)FDG-PET did not change clinical management in the vast majority of patients previously evaluated by CT. In addition, (18)FDG-PET missed >10% of periampullary malignancies and did not provide the anatomical detail necessary to define unresectabilty.

Full Text

Duke Authors

Cited Authors

  • Kalady, MF; Clary, BM; Clark, LA; Gottfried, M; Rohren, EM; Coleman, RE; Pappas, TN; Tyler, DS

Published Date

  • October 2002

Published In

Volume / Issue

  • 9 / 8

Start / End Page

  • 799 - 806

PubMed ID

  • 12374664

Pubmed Central ID

  • 12374664

International Standard Serial Number (ISSN)

  • 1068-9265

Digital Object Identifier (DOI)

  • 10.1007/BF02574503


  • eng

Conference Location

  • United States