Utility of 18F-FDG PET/CT for Differentiation of Autoimmune Pancreatitis With Atypical Pancreatic Imaging Findings From Pancreatic Cancer
- 1 August 2009
- journal article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 193 (2), 343-348
- https://doi.org/10.2214/ajr.08.2297
Abstract
OBJECTIVE. This study was conducted to evaluate the clinical usefulness of PET/CT in differentiating autoimmune pancreatitis from pancreatic cancer. MATERIALS AND METHODS. To differentiate autoimmune pancreatitis from pancreatic cancer, we analyzed the cases of 17 patients with autoimmune pancreatitis and atypical pancreatic imaging findings who underwent integrated PET/CT. The PET/CT findings on the 17 patients with autoimmune pancreatitis were compared with those of 151 patients with pancreatic cancer. RESULTS. Flourine-18 FDG uptake by the pancreas was found in all patients with autoimmune pancreatitis and in 82% (124/151) of patients with pancreatic cancer. Diffuse uptake by the pancreas was significantly more frequent in patients with autoimmune pancreatitis (53% vs 3%, p < 0.001). FDG uptake by the salivary glands and kidneys was seen only in patients with autoimmune pancreatitis, the former reaching statistical significance (p = 0.003). Follow-up PET/CT after steroid therapy was performed for eight patients with autoimmune pancreatitis. After steroid therapy, none of the patients had intense FDG uptake by the pancreas or extrapancreatic organs. CONCLUSION. In difficult cases, at PET/CT the presence of diffuse uptake of FDG by the pancreas or concomitant extrapancreatic uptake by the salivary glands can be used to aid in differentiation of autoimmune pancreatitis and pancreatic cancer.Keywords
This publication has 21 references indexed in Scilit:
- The efficacy of whole-body FDG-PET or PET/CT for autoimmune pancreatitis and associated extrapancreatic autoimmune lesionsEuropean Journal of Nuclear Medicine and Molecular Imaging, 2007
- Difficulty in diagnosing autoimmune pancreatitis by imaging findingsGastrointestinal Endoscopy, 2007
- Autoimmune PancreatitisThe New England Journal of Medicine, 2006
- Autoimmune pancreatitis: proposal of IgG4-related sclerosing diseaseThe Esophagus, 2006
- Diagnostic criteria for autoimmune chronic pancreatitis revisitedWorld Journal of Gastroenterology, 2006
- Autoimmune Chronic PancreatitisThe American Journal of Gastroenterology, 2004
- Clinical and Imaging Features of Autoimmune Pancreatitis With Focal Pancreatic Swelling Or Mass Formation: Comparison With So-Called Tumor-Forming Pancreatitis and Pancreatic CarcinomaThe American Journal of Gastroenterology, 2003
- Clinical Difficulties in The Differentiation of Autoimmune Pancreatitis and Pancreatic CarcinomaThe American Journal of Gastroenterology, 2003
- Autoimmune related pancreatitisGut, 2002
- FDG-PET of autoimmune-related pancreatitis: preliminary results.European Journal of Nuclear Medicine and Molecular Imaging, 2000