Santhosh Sampath, Mittal Bhagwant Rai, Bhasin Deepak Kumar, Rana Surinder Singh, Gupta Rajesh, Das Ashim, Nada Ritambhra
Institute of Nuclear Imaging and Molecular Medicine, Tamil Nadu Government Multi Super Specialty Hospital, Omandurar Government Estate, Anna Salai, Chennai, Tamil Nadu, 600002, India.
Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Ann Nucl Med. 2017 Oct;31(8):575-581. doi: 10.1007/s12149-017-1193-0. Epub 2017 Jul 8.
To evaluate the additional role of FDG-PET/CT to the conventional multiphasic CECT in the initial staging of pancreatic adenocarcinoma.
54 patients diagnosed with pathologically proven pancreatic malignancy underwent FDG-PET/CECT. The sensitivity, specificity, PPV, NPV, and accuracy of PET/CT and CECT for nodal and metastatic staging were calculated. The statistical difference was calculated by McNemar's test.
Of 54 patients, 15 had distal metastasis. The sensitivity, specificity, PPV, NPV, and accuracy of PET/CT and CECT for nodal staging were 33 vs 89%, 84 vs 100%, 67 vs 100%, 60 vs 90%, and 59 vs 95%, respectively, p < 0.001. The sensitivity, specificity, PPV, NPV, and accuracy of CECT for metastatic staging were 73, 87, 69, 89, and 83%, whereas the accuracy of PET/CT was 100%, p = 0.01. By correctly characterizing unsuspected distant lesions, PET/CT could change management in 19% of patients.
FDG-PET/CT can contribute to change in the management in almost one of every five patients of PA evaluated with the standard investigations during the initial staging.
评估氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）在胰腺腺癌初始分期中相对于传统多期计算机断层扫描（CECT）的额外作用。
54例经病理证实为胰腺恶性肿瘤的患者接受了FDG-PET/CECT检查。计算PET/CT和CECT在淋巴结及转移灶分期方面的敏感性、特异性、阳性预测值、阴性预测值和准确性。采用McNemar检验计算统计学差异。
54例患者中，15例有远处转移。PET/CT和CECT在淋巴结分期方面的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为33%对89%、84%对100%、67%对100%、60%对90%和59%对95%，p<0.001。CECT在转移灶分期方面的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为73%、87%、69%、89%和83%，而PET/CT的准确性为100%，p = 0.01。通过正确识别未被怀疑的远处病变（转移灶），PET/CT可使1 / 5的患者改变治疗方案。
在初始分期中，对于近五分之一接受标准检查评估的胰腺腺癌患者，FDG-PET/CT有助于改变其治疗方案。
