Clinical Application of FDG-PET in Biliary- pancreatic Malignancy

ABSTRACT

PURPOSE: This study was done to review our clinical experience of fluorodeoxyglucose (FDG)-positron emission tomography (PET) in biliary-pancreatic malignancies, and evaluated its diagnostic accuracy and usefulness. METHODS: FDG-PET was performed in 15 patients with biliary-pancreatic malignancies, to determine the extent of the disease (n=9) and to detect the recurrence (n=6). RESULTS: Of the 9 patients with a suspected loco-regional spread, 6 patients were disclosed by FDG-PET as having multiple metastasis to the regional lymph nodes and extraperitoneal organs, but the other 3 showed no evidence of regional or distant metastasis. Thus, FDG-PET performed preoperatively to estimate the extent of the disease, showed sensitivity and specificity of 100%, respectively. However, for the detection of a recurrent disease only 3 out of 5 with recurrent diseases were detected by FDG-PET (sensitivity 60%). FDG-PET revealed one suspected recurrent lesion, but a computed tomography (CT) scan showed no evidence of a recurrence. Due to the 2 false-negative results, the overall sensitivity and specificity of this study were 81.8 (9/11) and 100% (4/4), respectively. CONCLUSION: Unnecessary surgical procedures were avoided in 6 cases, and 3 curative surgeries aborted through the use of FDG-PET. Despite the lack of cases, FDG-PET was useful in estimating the extent of a disease, but was unsatisfactory in detecting a recurrent disease compared to CT. Coupled with conventional imaging, FDG-PET may also provide more helpful information for biliary-pancreatic malignancies as well.