Jiang Lei, Tang Qiying, Panje Cedric M, Nie Hongting, Zhao Guochao, Shi Hongcheng
Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China.
Nuclear Medicine Institute of Fudan University, Shanghai 200032, P.R. China.
Oncol Lett. 2018 Aug;16(2):1557-1564. doi: 10.3892/ol.2018.8859. Epub 2018 May 31.
Pancreatic colloid carcinoma (CC) is a rare sub-type of pancreatic adenocarcinoma which has an improved prognosis compared with pancreatic ductal carcinoma. Consequently, the early detection of CC by imaging may be of great significance in guiding patient management and therapeutic decisions. The present study aimed to analyze F-FDG PET/CT findings of CC in comparison to MRI and CT. PET/CT findings in 5 patients with CC were retrospectively reviewed based on visual interpretation and semi-quantitative index of SUV and TNR. Four patients received dual-time-point PET/CT scans. Additionally, one patient underwent contrast-enhanced CT scan, one MRI, and three received both. A total of five lesions were detected in five patients. Visually, two cases presented with mild FDG uptake, two with moderate and one with high. The mean of SUV and TNR was 5.1±2.2 and 2.8±0.7, respectively. Compared with CCs with low SUV, CCs with high SUV were more aggressive. No distant metastases were observed in five cases. Among four patients with dual-time-point PET/CT imaging, SUV increased in three cases and decreased in one case. The mean early and delayed SUV were 4.2±1.1 and 4.7±1.9, respectively (P>0.05). Radiological findings mainly included septated cystic components, internal sponge-like contrast-enhancement, calcification and 'salt-and-pepper sign' on MRI T2-weighted imaging. Thus, PET/CT provided additional information on metabolic tumor activity as well as locoregional and distant staging, which are important prognostic markers and may improve further patient management. However, PET/CT did not show any findings in addition to MRI and contrast-enhanced CT that were unique to CC and allowed a clear differentiation from other pancreatic malignancies.
胰腺胶样癌（CC）是胰腺腺癌的一种罕见亚型，与胰腺导管癌相比，其预后较好。因此，通过影像学早期发现CC对于指导患者管理和治疗决策可能具有重要意义。本研究旨在分析CC的F-FDG PET/CT表现，并与MRI和CT进行比较。基于视觉解读以及SUV和TNR的半定量指标，对5例CC患者的PET/CT表现进行了回顾性分析。4例患者接受了双时相PET/CT扫描。此外，1例患者接受了增强CT扫描，1例接受了MRI检查，3例同时接受了这两种检查。5例患者共检测到5个病灶。从视觉上看，2例表现为轻度FDG摄取，2例为中度摄取，1例为高度摄取。SUV和TNR的平均值分别为5.1±2.2和2.8±0.7。与低SUV的CC相比，高SUV的CC侵袭性更强。5例均未观察到远处转移。在4例接受双时相PET/CT成像的患者中，3例SUV升高，1例降低。早期和延迟SUV的平均值分别为4.2±1.1和4.7±1.9（P>0.05）。影像学表现主要包括分隔的囊性成分、内部海绵状强化、钙化以及MRI T2加权成像上的“椒盐征”。因此，PET/CT提供了关于代谢肿瘤活性以及局部和远处分期的额外信息，这些都是重要的预后标志物，可能会改善进一步的患者管理。然而，PET/CT除了显示出MRI和增强CT的表现外，没有显示出任何CC特有的、能与其他胰腺恶性肿瘤明确区分的表现。
