Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospitals of Geneva, Switzerland.
J Gastroenterol Hepatol. 2011 Apr;26(4):657-62. doi: 10.1111/j.1440-1746.2010.06525.x.
Positron Emission Tomography (PET) using (18)F-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.
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.
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).
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.
正电子发射断层扫描（PET）联合（18）F-氟脱氧葡萄糖（FDG）和计算机断层扫描（CT）已越来越多地用于胰腺癌的检测和分期，但关于其在术前规划中的临床附加价值的数据仍然缺乏。本研究旨在探讨 FDG PET 联合增强 CT 在胰腺癌检测中的性能。
我们前瞻性地评估了 2006 年 5 月至 2008 年 1 月间疑似可手术胰腺癌患者的 FDG PET/CT 研究。根据标准化方案进行分期，所有患者均通过手术切除或活检检查确认了结果。
本研究共纳入 45 例中位年龄为 69 岁（范围 22-82 岁）的患者。36 例患者为恶性肿瘤，9 例为良性病变（20%）。增强与非增强 PET/CT 检测胰腺癌的敏感性分别为 96%和 72%（P=0.076），特异性分别为 66.6%和 33.3%（P=0.52），阳性预测值分别为 92.3%和 80%（P=0.3），阴性预测值分别为 80%和 25%（P=0.2），准确性分别为 90.3%和 64%（P=0.085）。
我们在有限数量的患者中获得的初步数据表明，增强 FDG PET/CT 在检测和评估胰腺癌方面具有良好的敏感性，但特异性相对较低。增强 PET/CT 似乎优于非增强 PET/CT。需要进一步的更大规模的前瞻性研究来确定其在胰腺癌术前诊断和分期中的价值。
