Iwasa Hitomi, Murata Yoriko, Nishimori Miki, Miyatake Kana, Kohsaki Shino, Hayashi Naoya, Akagi Naoki, Kohsaki Takuhiro, Uchida Kazushige, Yamagami Takuji
Department of Radiology, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan.
Department of Radiology, Health care system JINSEI-KAI Hosogi Hospital, Kochi 780-0926, Japan.
Oncol Lett. 2021 Apr;21(4):270. doi: 10.3892/ol.2021.12531. Epub 2021 Feb 9.
To evaluate the breakdown of unexpected pancreatic F-fluorodeoxyglucose (FDG) uptake and the proportion of secondary primary pancreatic cancer on follow-up, patients with cancer underwent positron emission tomography/computed tomography (PET/CT). The participants consisted of 4,473 consecutive patients with cancer who underwent follow-up PET/CT between January 2015 and March 2019 at Kochi Medical School. Among the participants, 225 with a history of pancreatic cancer were excluded from the present study. Retrospective and blinded PET/CT evaluations of 4,248 patients were performed. In patients with pancreatic FDG uptake, the distribution of FDG uptake in the pancreas was evaluated. The final diagnosis was determined pathologically. A total of 14 (0.3%) of the 4,248 patients exhibited FDG uptake in the pancreatic area. Pancreatic abnormalities were detected in 14 patients, and included five cases of pancreatic metastases (36%), four cases of secondary primary pancreatic cancer (29%), two cases of lymph node metastases (14%), one case of malignant lymphoma (7%), one case of autoimmune pancreatitis (7%) and one case of pseudolesion (7%). One patient with early-stage secondary primary pancreatic cancer had a maximum standardized uptake value (SUV) <3.0. The remaining 13 patients had a SUV >3.0 in the pancreas. Of the 14 patients, two had multiple foci of FDG uptake in the pancreas. Patients with multiple foci of FDG uptake exhibited pancreatic metastasis from renal cell carcinoma and malignant lymphoma. In conclusion, the majority of patients with unexpected pancreatic FDG uptake on follow-up PET/CT exhibited malignancies; furthermore, ~30% of the malignancies detected in patients with pancreatic FDG uptake were secondary primary pancreatic cancers. In patients with unexpected pancreatic FDG uptake on follow-up PET/CT, primary cancer should be considered as well as metastatic tumors.
为了评估随访期间意外出现的胰腺氟脱氧葡萄糖（FDG）摄取情况以及继发性原发性胰腺癌的比例，癌症患者接受了正电子发射断层扫描/计算机断层扫描（PET/CT）检查。研究对象包括2015年1月至2019年3月在高知医科大学连续接受随访PET/CT检查的4473例癌症患者。其中，225例有胰腺癌病史的患者被排除在本研究之外。对4248例患者进行了回顾性和盲法PET/CT评估。在胰腺有FDG摄取的患者中，评估了胰腺内FDG摄取的分布情况。最终诊断通过病理确定。4248例患者中共有14例（0.3%）在胰腺区域出现FDG摄取。14例患者检测到胰腺异常，包括5例胰腺转移（36%）、4例继发性原发性胰腺癌（29%）、2例淋巴结转移（14%）、1例恶性淋巴瘤（7%）、1例自身免疫性胰腺炎（7%）和1例假病变（7%）。1例早期继发性原发性胰腺癌患者的最大标准化摄取值（SUV）<3.0。其余13例患者胰腺的SUV>3.0。14例患者中，2例胰腺有多个FDG摄取灶。有多个FDG摄取灶的患者表现为肾细胞癌和恶性淋巴瘤的胰腺转移。总之，随访PET/CT检查中意外出现胰腺FDG摄取的大多数患者表现为恶性肿瘤；此外，在胰腺FDG摄取患者中检测到的恶性肿瘤约30%为继发性原发性胰腺癌。在随访PET/CT检查中意外出现胰腺FDG摄取的患者，应同时考虑原发性癌症和转移性肿瘤。
