（18）氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在可切除胰腺癌中的作用

The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in resectable pancreatic cancer.

作者信息

Crippa Stefano, Salgarello Matteo, Laiti Silvia, Partelli Stefano, Castelli Paola, Spinelli Antonello E, Tamburrino Domenico, Zamboni Giuseppe, Falconi Massimo

机构信息

Division of Pancreatic Surgery, Department of Surgery, Università Politecnica delle Marche, Ospedali Riuniti, Ancona, Italy.

Department of Nuclear Medicine, University of Verona, Negrar, Italy.

出版信息

Dig Liver Dis. 2014 Aug;46(8):744-9. doi: 10.1016/j.dld.2014.03.011. Epub 2014 Apr 8.

DOI:10.1016/j.dld.2014.03.011

PMID:24721105

Abstract

BACKGROUND

The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in pancreatic ductal adenocarcinoma is debated. We retrospectively assessed the value of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer.

METHODS

(18)Fluoro-deoxyglucose positron emission tomography/computed tomography was performed in 72 patients with resectable pancreatic carcinoma after multi-detector computed tomography positron emission tomography was considered positive for a maximum standardized uptake value >3.

RESULTS

Overall, 21% of patients had a maximum standardized uptake value ≤ 3, and 60% of those had undergone neoadjuvant treatment (P=0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8 U/mL for the entire cohort and 292 U/mL for metastatic patients (P=0.112).

CONCLUSIONS

The widespread application of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in patients with resectable pancreatic carcinoma seems not justified. It should be considered in selected patients at higher risk of metastatic disease (i.e. CA19.9>200 U/mL) after undergoing other imaging tests. Neoadjuvant treatment is significantly associated with low metabolic activity, limiting the value of positron emission tomography in this setting.

摘要

背景

18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在胰腺导管腺癌中的作用存在争议。我们回顾性评估了18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描联合传统成像作为胰腺癌分期方式的价值。

方法

72例可切除胰腺癌患者在多排计算机断层扫描正电子发射断层扫描显示最大标准化摄取值>3被认为呈阳性后，接受了18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描。

结果

总体而言，21%的患者最大标准化摄取值≤3，其中60%接受了新辅助治疗（P = 0.0001）。此外，11%的患者因正电子发射断层扫描/计算机断层扫描检测到转移性疾病而避免了不必要的手术。所有肝转移随后均通过对比增强超声得以识别。正电子发射断层扫描/计算机断层扫描对远处转移的敏感性和特异性分别为78%和100%。整个队列的CA19.9浓度中位数为48.8 U/mL，转移患者为292 U/mL（P = 0.112）。