Serafini Simone, Sperti Cosimo, Brazzale Alessandra Rosalba, Cecchin Diego, Zucchetta Pietro, Pierobon Elisa Sefora, Ponzoni Alberto, Valmasoni Michele, Moletta Lucia
Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, 35122 Padua, Italy.
Department of Statistical Sciences, University of Padua, 35122 Padua, Italy.
Cancers (Basel). 2020 Mar 27;12(4):807. doi: 10.3390/cancers12040807.
Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas represent a heterogeneous group of tumors, increasingly diagnosed in clinical practice. An early differential diagnosis between malignant and benign lesions is crucial to patient management and the choice of surgery or observation. The therapeutic approach is currently based on a patient's clinical, biochemical, and morphological characteristics. The latest published International Consensus Guidelines (ICG) make no mention of the role of metabolic assessments of IPMNs. The aim of this study was to review the current literature, examining the role of 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in IPMN management. An extensive literature review was conducted according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and 10 articles were analyzed in detail, focusing on the value of PET as opposed to other standard imaging criteria. Data were retrieved on 419 patients. The 18-FDG-PET proved more sensitive, specific, and accurate than the ICG criteria in detecting malignant IPMNs (reaching 80%, 95%, and 87% vs. 67%, 58%, and 63%, respectively). Metabolic assessments may be used as an additional tool for the appropriate management of patients with doubtful imaging findings.
胰腺导管内乳头状黏液性肿瘤（IPMNs）是一组异质性肿瘤，在临床实践中的诊断越来越多。恶性和良性病变的早期鉴别诊断对于患者管理以及手术或观察的选择至关重要。目前的治疗方法基于患者的临床、生化和形态学特征。最新发布的国际共识指南（ICG）未提及IPMNs代谢评估的作用。本研究的目的是回顾当前文献，探讨18-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在IPMN管理中的作用。根据2009年系统评价和Meta分析的首选报告项目（PRISMA）指南进行了广泛的文献综述，并详细分析了10篇文章，重点关注PET相对于其他标准成像标准的价值。检索了419例患者的数据。在检测恶性IPMNs方面，18-FDG-PET比ICG标准更敏感、特异和准确（分别达到80%、95%和87%，而ICG标准分别为67%、58%和63%）。代谢评估可作为对影像表现可疑患者进行适当管理的额外工具。
