Skip to main content
SpringerLink
Log in

Contribution of 18F-fluorodeoxyglucose positron emission tomography to the diagnosis of early pancreatic carcinoma

  • Original Article
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Background/Purpose

Pancreatic carcinoma has a poor prognosis, and early detection is essential to allow potentially curative resection. Despite the wide array of diagnostic tools available, the detection of small pancreatic tumors remains difficult. The aim of this study was to investigate the contribution of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to the diagnosis of early pancreatic cancer.

Methods

FDG-PET was performed in 56 patients with pancreatic cancer who underwent curative surgery. The standardized uptake value (SUV) for FDG was calculated in each patient and the relationships between the SUV and various clinicopathological factors were analyzed.

Results

The tumors ranged from 0.8 to 6.5 cm in diameter. When the cutoff value for the SUV was set at 2.5, 51 of the 56 patients (91%) had a positive FDG-PET study. The SUV did not show a significant difference in relation to tumor differentiation or pTS and pT factors. There was also no correlation between the SUV and the maximum tumor diameter (r = 0.22; P = 0.1). Five tumors had an SUV below the cutoff value, and all of these lesions had intermediate or scirrhous stroma rather than medullary stroma.

Conclusions

These results indicate that FDG-PET is useful for the detection of small early pancreatic cancers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fung MC, Sakata T. What’s new in pancreatic cancer treatment? J Hepatobiliary Pancreat Surg 2002;9:61–75.

    Article  PubMed  Google Scholar 

  2. Matsuno S, Egawa S, Arai K. Trends in treatment for pancreatic cancer. J Hepatobiliary Pancreat Surg 2001;8:544–548.

    Article  PubMed  CAS  Google Scholar 

  3. Yamamoto M, Ohashi O, Saitoh Y. Japan Pancreatic Cancer Registry: current status. Pancreas 1998;16:238–242.

    Article  PubMed  CAS  Google Scholar 

  4. Edge SB, Schmieg RE Jr, Rosenlof LK, Wilhelm MC. Pancreas cancer resection outcome in American University centers in 1989–1990. Cancer 1993;71:3502–3508.

    Article  PubMed  CAS  Google Scholar 

  5. Kawarada Y, Das BC, Naganuma T, Isaji S. Surgical treatment of pancreatic cancer. Does extended lymphadenectomy provide a better outcome? J Hepatobiliary Pancreat Surg 2001;8:224–229.

    Article  PubMed  CAS  Google Scholar 

  6. Imaizumi T, Hanyu F, Harada N, Hatori T, Fukuda A. Extended radical Whipple resection for cancer of the pancreatic head: operative procedure and results. Dig Surg 1998;15:299–307.

    Article  PubMed  CAS  Google Scholar 

  7. Nagakawa T, Nagamori M, Futakami F, Tsukioka Y, Kayahara M, Ohta T, et al. Results of extensive surgery for pancreatic carcinoma. Cancer 1996;77:640–645.

    Article  PubMed  CAS  Google Scholar 

  8. Niederhuber JE, Brennan MF, Menck HR. The National Cancer Data Base report on pancreatic cancer. Cancer 1995;76:1671–1677.

    Article  PubMed  CAS  Google Scholar 

  9. Nitecki SS, Sarr MG, Colby TV, van Heerden JA. Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving? Ann Surg 1995;221:59–66.

    Article  PubMed  CAS  Google Scholar 

  10. Livingston EH, Welton ML, Reber HA. Surgical treatment of pancreatic cancer. The United States experience. Int J Pancreatol 1991;9:153–157.

    Article  PubMed  CAS  Google Scholar 

  11. Trede M, Schwall G, Saeger HD. Survival after pancreatoduodenectomy. One hundred and eighteen consecutive resections without an operative mortality. Ann Surg 1990;211:447–458.

    Article  PubMed  CAS  Google Scholar 

  12. Cameron JL, Pitt HA, Yeo CJ, Lillemoe KD, Kaufman HS, Coleman J. One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann Surg 1993;217:430–435; discussion 5–8.

    Article  PubMed  CAS  Google Scholar 

  13. Cress RD, Yin D, Clarke L, Bold R, Holly EA. Survival among patients with adenocarcinoma of the pancreas: a population-based study (United States). Cancer Causes Control 2006;17:403–409.

    Article  PubMed  Google Scholar 

  14. Japan Pancreas Society. Classification of pancreatic carcinoma. 2nd English ed. Tokyo: Kanehara; 2003.

    Google Scholar 

  15. Seo S, Hatano E, Higashi T, Hara T, Tada M, Tamaki N, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography predicts tumor differentiation, P-glycoprotein expression, and outcome after resection in hepatocellular carcinoma. Clin Cancer Res 2007;13:427–433.

    Article  PubMed  CAS  Google Scholar 

  16. Murguia E, Quiroga D, Canteros G, Sanmartino C, Barreiro M, Herrera J. Gallbladder metastases from ductal papillary carcinoma of the breast. J Hepatobiliary Pancreat Surg 2006;13:591–593.

    Article  PubMed  Google Scholar 

  17. Chikamoto A, Tsuji T, Takamori H, Kanemitsu K, Uozumi H, Yamashita Y, et al. The diagnostic efficacy of FDG-PET in the local recurrence of hilar bile duct cancer. J Hepatobiliary Pancreat Surg 2006;13:403–408.

    Article  PubMed  Google Scholar 

  18. Maemura K, Takao S, Shinchi H, Noma H, Mataki Y, Kurahara H, et al. Role of positron emission tomography in decisions on treatment strategies for pancreatic cancer. J Hepatobiliary Pancreat Surg 2006;13:435–441.

    Article  PubMed  Google Scholar 

  19. Delbeke D, Pinson CW. Pancreatic tumors: role of imaging in the diagnosis, staging, and treatment. J Hepatobiliary Pancreat Surg 2004;11:4–10.

    Article  PubMed  Google Scholar 

  20. Inokuma T, Tamaki N, Torizuka T, Magata Y, Fujii M, Yonekura Y, et al. Evaluation of pancreatic tumors with positron emission tomography and F-18 fluorodeoxyglucose: comparison with CT and US. Radiology 1995;195:345–352.

    PubMed  CAS  Google Scholar 

  21. 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.

    Article  PubMed  CAS  Google Scholar 

  22. Yoshioka M, Sato T, Furuya T, Shibata S, Andoh H, Asanuma Y, et al. Role of positron emission tomography with 2-deoxy-2-[18F] fluoro-D-glucose in evaluating the effects of arterial infusion chemotherapy and radiotherapy on pancreatic cancer. J Gastroenterol 2004;39:50–55.

    Article  PubMed  Google Scholar 

  23. Lyshchik A, Higashi T, Hara T, Nakamoto Y, Fujimoto K, Doi R, et al. Expression of glucose transporter-1, hexokinase-II, proliferating cell nuclear antigen and survival of patients with pancreatic cancer. Cancer Invest 2007;25:154–162.

    Article  PubMed  CAS  Google Scholar 

  24. Matsuno S, Egawa S, Fukuyama S, Motoi F, Sunamura M, Isaji S, et al. Pancreatic Cancer Registry in Japan: 20 years of experience. Pancreas 2004;28:219–230.

    Article  PubMed  Google Scholar 

  25. Sener SF, Fremgen A, Menck HR, Winchester DP. Pancreatic cancer: a report of treatment and survival trends for 100 313 patients diagnosed from 1985–1995, using the National Cancer Database. J Am Coll Surg 1999;189:1–7.

    Article  PubMed  CAS  Google Scholar 

  26. Neoptolemos JP, Stocken DD, Friess H, Bassi C, Dunn JA, Hickey H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med 2004;350:1200–1210.

    Article  PubMed  CAS  Google Scholar 

  27. Sheridan MB, Ward J, Guthrie JA, Spencer JA, Craven CM, Wilson D, et al. Dynamic contrast-enhanced MR imaging and dual-phase helical CT in the preoperative assessment of suspected pancreatic cancer: a comparative study with receiver operating characteristic analysis. AJR Am J Roentgenol 1999;173:583–590.

    PubMed  CAS  Google Scholar 

  28. Ichikawa T, Haradome H, Hachiya J, Nitatori T, Ohtomo K, Kinoshita T, et al. Pancreatic ductal adenocarcinoma: preoperative assessment with helical CT versus dynamic MR imaging. Radiology 1997;202:655–662.

    PubMed  CAS  Google Scholar 

  29. Legmann P, Vignaux O, Dousset B, Baraza AJ, Palazzo L, Dumontier I, et al. Pancreatic tumors: comparison of dual-phase helical CT and endoscopic sonography. AJR Am J Roentgenol 1998;170:1315–1322.

    PubMed  CAS  Google Scholar 

  30. Tabuchi T, Itoh K, Ohshio G, Kojima N, Maetani Y, Shibata T, et al. Tumor staging of pancreatic adenocarcinoma using early-and late-phase helical CT. AJR Am J Roentgenol 1999;173:375–380.

    PubMed  CAS  Google Scholar 

  31. Irie H, Honda H, Kaneko K, Kuroiwa T, Yoshimitsu K, Masuda K. Comparison of helical CT and MR imaging in detecting and staging small pancreatic adenocarcinoma. Abdom Imaging 1997;22:429–433.

    Article  PubMed  CAS  Google Scholar 

  32. DeWitt J, Devereaux B, Chriswell M, McGreevy K, Howard T, Imperiale TF, et al. Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med 2004;141:753–763.

    PubMed  Google Scholar 

  33. Bronstein YL, Loyer EM, Kaur H, Choi H, David C, DuBrow RA, et al. Detection of small pancreatic tumors with multiphasic helical CT. AJR Am J Roentgenol 2004;182:619–623.

    PubMed  Google Scholar 

  34. Mehmet Erturk S, Ichikawa T, Sou H, Saitou R, Tsukamoto T, Motosugi U, et al. Pancreatic adenocarcinoma: MDCT versus MRI in the detection and assessment of locoregional extension. J Comput Assist Tomogr 2006;30:583–590.

    Article  PubMed  Google Scholar 

  35. Rigo P, Paulus P, Kaschten BJ, Hustinx R, Bury T, Jerusalem G, et al. Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose. Eur J Nucl Med 1996;23:1641–1674.

    Article  PubMed  CAS  Google Scholar 

  36. Eary JF, Conrad EU. Positron emission tomography in grading soft tissue sarcomas. Semin Musculoskelet Radiol 1999;3:135–138.

    Article  PubMed  Google Scholar 

  37. Stokkel MP, ten Broek FW, van Rijk PP. The role of FDG PET in the clinical management of head and neck cancer. Oral Oncol 1998;34:466–471.

    Article  PubMed  CAS  Google Scholar 

  38. Rose DM, Delbeke D, Beauchamp RD, Chapman WC, Sandler MP, Sharp KW, et al. 18 Fluorodeoxyglucose-positron emission tomography in the management of patients with suspected pancreatic cancer. Ann Surg 1999;229:729–737; discussion 37–38.

    Article  PubMed  CAS  Google Scholar 

  39. Berberat P, Friess H, Kashiwagi M, Beger HG, Buchler MW. Diagnosis and staging of pancreatic cancer by positron emission tomography. World J Surg 1999;23:882–887.

    Article  PubMed  CAS  Google Scholar 

  40. Sperti C, Pasquali C, Chierichetti F, Liessi G, Ferlin G, Pedrazzoli S. Value of 18-fluorodeoxyglucose positron emission tomography in the management of patients with cystic tumors of the pancreas. Ann Surg 2001;234:675–680.

    Article  PubMed  CAS  Google Scholar 

  41. Imdahl A, Nitzsche E, Krautmann F, Hogerle 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.

    Article  PubMed  CAS  Google Scholar 

  42. Clark L, Perez-Tamayo RA, Hurwitz H, Branch S, Baillie J, Jowell P, et al. The role of positron emission tomography in the diagnosis and staging of pancreatic cancer (abstract). Gastroenterology 1998;114:S0044.

    Google Scholar 

  43. Yonekura Y, Benua RS, Brill AB, Som P, Yeh SD, Kemeny NE, et al. Increased accumulation of 2-deoxy-2-[18F] fluoro-D-glucose in liver metastases from colon carcinoma. J Nucl Med 1982;23:1133–1137.

    PubMed  CAS  Google Scholar 

  44. Higashi T, Tamaki N, Torizuka T, Nakamoto Y, Sakahara H, Kimura T, et al. FDG uptake, GLUT-1 glucose transporter and cellularity in human pancreatic tumors. J Nucl Med 1998;39:1727–1735.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Satoru Seo, Ryuichiro Doi, Takafumi Machimoto, Kazuhiro Kami, Toshihiko Masui, Etsuro Hatano, Kohei Ogawa & Shinji Uemoto

  2. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan

    Tatsuya Higashi

Authors
  1. Satoru Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryuichiro Doi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takafumi Machimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazuhiro Kami
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toshihiko Masui
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Etsuro Hatano
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kohei Ogawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tatsuya Higashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Shinji Uemoto
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Seo, S., Doi, R., Machimoto, T. et al. Contribution of 18F-fluorodeoxyglucose positron emission tomography to the diagnosis of early pancreatic carcinoma. J Hepatobiliary Pancreat Surg 15, 634–639 (2008). https://doi.org/10.1007/s00534-007-1339-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-007-1339-x

Key words

Search

Navigation