Value of contrast‐enhanced 18F‐fluorodeoxyglucose positron emission tomography/computed tomography in detection and presurgical assessment of pancreatic cancer: A prospective study

Abstract

Background and Aim: Positron Emission Tomography (PET) using ¹⁸F‐fluorodeoxyglucose (FDG) associated with computed tomography (CT) is increasingly used for the detection and the staging of pancreatic cancer, but data regarding its clinical added value in pre‐surgical planning is still lacking. The aim of this study is to investigate the performance of FDG PET associated with contrast‐enhanced CT in detection of pancreatic cancer. Methods: We prospectively evaluated FDG PET/CT studies obtained in patients with suspicion of operable pancreatic cancer between May 2006 and January 2008. Staging was conducted according to a standardized protocol, and findings were confirmed in all patients by surgical resection or biopsy examination. Results: Forty‐five patients with a median age of 69 (range 22–82) were included in this study. Thirty‐six had malignant tumors and nine had benign lesions (20%). The sensitivity of enhanced versus unenhanced PET/CT in the detection of pancreatic cancer was 96% versus 72% (P = 0.076), the specificity 66.6% versus 33.3% (P = 0.52), the positive predictive value 92.3% versus 80% (P = 0.3), the negative predictive value 80% versus 25% (P = 0.2), and the accuracy 90.3% versus 64% (P = 0.085). Conclusions: Our preliminary data obtained in a limited number of patients shows that contrast‐enhanced FDG PET/CT offers good sensitivity in the detection and assessment of pancreatic cancer, but at the price of a relatively low specificity. Enhanced PET/CT seems to be superior to unenhanced PET/CT. Further larger prospective studies are needed to establish its value for pre‐surgical diagnosis and staging in pancreatic cancer.