Simplified dual time point FDG-PET/computed tomography for determining dignity of pancreatic lesions.
Journal
Nuclear medicine communications
ISSN: 1473-5628
Titre abrégé: Nucl Med Commun
Pays: England
ID NLM: 8201017
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
pubmed:
15
5
2020
medline:
26
3
2021
entrez:
15
5
2020
Statut:
ppublish
Résumé
Predicting the dignity of pancreatic lesions is still a diagnostic challenge. The differentiation between benign changes in chronic pancreatitis from pancreatic cancer remains difficult. Therefore, the aim of this study was to evaluate whether early dual time point kinetics of pancreatic lesions in 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) may be helpful to differentiate pancreatic lesions. We prospectively analyzed 64 patients (pancreatic cancer n = 45 and chronic pancreatitis n = 19) scheduled for dual time point FDG-PET/computed tomography scan for pancreatic lesions from 2005 to 2014. Studies were performed 60 and 90 minutes after application of F-FDG. Histological samples were collected for all patients, either by resection or by biopsy. Semiquantitative analysis was performed using the minimum, the maximum, and the average standardized uptake value (SUV) from the two different sets of images. To increase sensitivity and specificity, a formula addressing the weighting of standardized uptake values was created. With a sensitivity of 82.6%, specificity of 77.8%, accuracy of 79.7%, positive predictive value of 90.5%, and negative predictive value of 63.6% SUVmax@time1 > 3.45 was the most reliable single quantitative parameter for malignancy of the pancreatic lesions. Weighting of standardized uptake values produced a formula that showed an even better profile. In patients with suspicious pancreatic lesions, the simplified dual time point FDG-PET/computed tomography may represent a valuable diagnostic tool in characterizing pancreatic lesions.
Sections du résumé
BACKGROUND
BACKGROUND
Predicting the dignity of pancreatic lesions is still a diagnostic challenge. The differentiation between benign changes in chronic pancreatitis from pancreatic cancer remains difficult. Therefore, the aim of this study was to evaluate whether early dual time point kinetics of pancreatic lesions in 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) may be helpful to differentiate pancreatic lesions.
METHODS
METHODS
We prospectively analyzed 64 patients (pancreatic cancer n = 45 and chronic pancreatitis n = 19) scheduled for dual time point FDG-PET/computed tomography scan for pancreatic lesions from 2005 to 2014. Studies were performed 60 and 90 minutes after application of F-FDG. Histological samples were collected for all patients, either by resection or by biopsy. Semiquantitative analysis was performed using the minimum, the maximum, and the average standardized uptake value (SUV) from the two different sets of images. To increase sensitivity and specificity, a formula addressing the weighting of standardized uptake values was created.
RESULTS
RESULTS
With a sensitivity of 82.6%, specificity of 77.8%, accuracy of 79.7%, positive predictive value of 90.5%, and negative predictive value of 63.6% SUVmax@time1 > 3.45 was the most reliable single quantitative parameter for malignancy of the pancreatic lesions. Weighting of standardized uptake values produced a formula that showed an even better profile.
CONCLUSIONS
CONCLUSIONS
In patients with suspicious pancreatic lesions, the simplified dual time point FDG-PET/computed tomography may represent a valuable diagnostic tool in characterizing pancreatic lesions.
Identifiants
pubmed: 32404649
doi: 10.1097/MNM.0000000000001191
pii: 00006231-202007000-00009
doi:
Substances chimiques
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
682-687Références
Wild CP, Weiderpass E, Stewart BW. World Cancer Report: Cancer Research for Cancer Prevention; Lyon:. International Agency for Research on Cancer. 202023–34
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012; 380:2095–2128
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015; 65:87–108
Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS. National failure to operate on early stage pancreatic cancer. Ann Surg. 2007; 246:173–180
Thota R, Pauff JM, Berlin JD. Treatment of metastatic pancreatic adenocarcinoma: a review. Oncology (Williston Park). 2014; 28:70–74
American Cancer Society. Cancer Facts & Figures 2020. 2020, Atlanta; GA: American Cancer Society
Ho CK, Kleeff J, Friess H, Büchler MW. Complications of pancreatic surgery. HPB (Oxford). 2005; 7:99–108
Kubota K, Itoh M, Ozaki K, Ono S, Tashiro M, Yamaguchi K, et al. Advantage of delayed whole-body FDG-PET imaging for tumour detection. Eur J Nucl Med. 2001; 28:696–703
Matthies A, Hickeson M, Cuchiara A, Alavi A. Dual time point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med. 2002; 43:871–875
Westerterp M, Pruim J, Oyen W, Hoekstra O, Paans A, Visser E, et al. Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction, resolution and ROI definition parameters. Eur J Nucl Med Mol Imaging. 2007; 34:392–404
Vriens D, Visser EP, de Geus-Oei LF, Oyen WJ. Methodological considerations in quantification of oncological FDG PET studies. Eur J Nucl Med Mol Imaging. 2010; 37:1408–1425
Nakata B, Nishimura S, Ishikawa T, Ohira M, Nishino H, Kawabe J, et al. Prognostic predictive value of 18F-fluorodeoxyglucose positron emission tomography for patients with pancreatic cancer. Int J Oncol. 2001; 19:53–58
van Heertum RL, Fawwaz RA. The role of nuclear medicine in the evaluation of pancreatic disease. Surg Clin North Am. 2001; 81:345–358
Nakamoto Y, Higashi T, Sakahara H, Tamaki N, Kogire M, Doi R, et al. Delayed (18)F-fluoro-2-deoxy-D-glucose positron emission tomography scan for differentiation between malignant and benign lesions in the pancreas. Cancer. 2000; 89:2547–2554
Imdahl A, Nitzsche E, Krautmann F, Högerle S, Boos S, Einert A, et al. Evaluation of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose for the differentiation of chronic pancreatitis and pancreatic cancer. Br J Surg. 1999; 86:194–199
Bosman FT, Carneiro F, Hruban RH, Theise NN. WHO classification of tumours of the digestive system. 20195th ed, Lyon: International Agency for Research on Cancer295–370
Youden WJ. Index for rating diagnostic tests. Cancer. 1950; 3:32–35
Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem. 1993; 39:561–577
Nitzsche EU, Hoegerle S, Mix M, Brink I, Otte A, Moser E, Imdahl A. Non-invasive differentiation of pancreatic lesions: is analysis of FDG kinetics superior to semiquantitative uptake value analysis? Eur J Nucl Med Mol Imaging. 2002; 29:237–242
Shinya T, Sato S, Kunisada T, Inai R, Yanai H, Ozaki T, Kanazawa S. Both a visual and a semiquantitative analysis for differentiating benign from malignant chondrogenic bone tumors using tc-99m (V) DMSA scintigraphy: a prospective study. Nucl Med Commun. 2015; 36:802–807
Saleh Farghaly HR, Mohamed Sayed MH, Nasr HA, Abdelaziz Maklad AM. Dual time point fluorodeoxyglucose positron emission tomography/computed tomography in differentiation between malignant and benign lesions in cancer patients. Does it always work? Indian J Nucl Med. 2015; 30:314–319
Sa R, Zhao HG, Dai YY, Guan F. The role of dual time point PET/CT for distinguishing malignant from benign focal 18F-FDG uptake duodenal lesions. Medicine (Baltimore). 2018; 97:e12521
Joo I, Lee JM, Lee DH, Lee ES, Paeng JC, Lee SJ, et al. Preoperative assessment of pancreatic cancer with FDG PET/MR imaging versus FDG PET/CT plus contrast-enhanced multidetector CT: a prospective preliminary study. Radiology. 2017; 282:149–159