Diagnostic Role of F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Characterization of Intraductal Papillary Mucinous Neoplasms

Abstract

Objectives:The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (CT) for characterization of intraductal papillary mucinous neoplasms (IPMN) through a systematic review and meta-analysis. Methods:The PubMed and Embase database were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for characterization of IPMN.Results: Across 14 studies (752 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.84 (95% confidence interval [CI], 0.77-0.89) with heterogeneity (I 2 = 55.5, P = 0.01) and a pooled specificity of 0.95 (95% CI, 0.88-0.98) with heterogeneity (I 2 = 83.9, P < 0.001). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 17.4 (95% CI, 6.5-46.8) and negative likelihood ratio (LR−) of 0.17 (95% CI, 0.12-0.25). The pooled diagnostic odds ratio was 101 (95% CI, 31-327). Hierarchical summary receiver operating characteristic curve and indicates that the areas under the curve were 0.93 (95% CI, 0.90-0.95). Conclusions:The current meta-analysis showed a high sensitivity, specificity, diagnostic odds ratio, and the LR scatter gram of F-18 FDG PET or PET/CT for determination of characteristics of IPMN.

Comparison of Preoperative Imaging Modalities for the Assessment of Malignant Potential of Pancreatic Cystic Lesions

“…9,10 PET or PET/CT with 18 F-FDG has shown high diagnostic performance for identifying malignancy in IPMNs and PCLs. 11,12 Pedrazzoli et al 13 reported that PET is more accurate than the ICGs in distinguishing benign from malignant IPMNs, and they suggested that PET should be performed in patients with old age or high surgical risk to avoid the unnecessary resection of benign lesions. However, because of lack of large-scale comparative studies, metabolic information provided by 18 F-FDG PET has not yet been adopted by ICG as other guidelines of the American College of Gastroenterology, American Gastroenterological Association, or European Study Group on Cystic Tumors of the Pancreas.…”

“…PET or PET/CT with 18 F-FDG has shown high diagnostic performance for identifying malignancy in IPMNs and PCLs 11,12 . Pedrazzoli et al 13 reported that PET is more accurate than the ICGs in distinguishing benign from malignant IPMNs, and they suggested that PET should be performed in patients with old age or high surgical risk to avoid the unnecessary resection of benign lesions.…”