Focal fluorine-18 fluorodeoxyglucose accumulation in inflammatory pancreatic disease

Shreve, Paul

doi:10.1007/s002590050226

Cited by 146 publications

(74 citation statements)

References 12 publications

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“…Though FDG-PET is a sensitive diagnostic modality in detecting malignant tumors, inflammation can give rise to FDG uptake in the same intensity range as pancreatic neoplasm 18 . In chronic pancreatitis, tumors detected by FDG-PET consist of degenerative necrosis surrounded by granulation tissue 29 .…”

Section: Discussionmentioning

confidence: 99%

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Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography

et al. 2008

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Purposes: Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely used for the diagnosis of pancreatic cancer. Because autoimmune pancreatitis is easily misdiagnosed as pancreatic cancer and can be tested for by FDG-PET analysis based on the presence of suspected pancreatic cancer, we attempted to clarify the differences in FDG-PET findings between the two conditions. Methods: We compared the FDG-PET findings between 15 patients with autoimmune pancreatitis and 26 patients with pancreatic cancer. The findings were evaluated visually or semiquantitatively using the maximum standardized uptake value and the accumulation pattern of FDG. Results: FDG uptake was found in all 15 patients with autoimmune pancreatitis, whereas it was found in 19 of 26 patients (73.1%) with pancreatic cancer. The accumulation pattern of nodular shape was frequently seen in pancreatic cancer with significance, whereas a longitudinal shape indicated the existence of autoimmune pancreatitis. Heterogeneous accumulation was found in almost all cases of autoimmune pancreatitis, whereas homogeneous accumulation was found in pancreatic cancer. Most cases of pancreatic cancer showed solitary localization with significant difference, whereas multiple localizations in the pancreas favored the existence of autoimmune pancreatitis. FDG uptakes in the hilar lymph node were more frequently seen in autoimmune pancreatitis than in pancreatic cancer with significance, and those in the lachrymal gland, salivary gland, biliary duct, retroperitoneal space, and prostate were only seen in autoimmune pancreatitis. Conclusions: FDG-PET provides a useful tool for differentiating autoimmune pancreatitis from suspected pancreatic cancer, if its accumulation pattern and extra-pancreatic involvements are considered. IgG4 measurement and other current image tests will confirm further diagnosis.

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Section: Discussionmentioning

confidence: 99%

“…However, FDG-PET cannot always differentiate between such lesions 17,18 , since the inflammatory foci of the pancreas also accumulates FDG 19,20,21,22 . In addition, previous reports have shown that patients with autoimmune pancreatitis also show intense FDG uptake 19,23,24 .…”

Section: Introductionmentioning

confidence: 99%

Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography

et al. 2008

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“…FDG is not a cancer-specific agent and is known to accumulate in cases of acute inflammation in granulomatous diseases and in autoimmune diseases [20][21][22]. Under such conditions, the suggestion is that 18 F-FDG is taken up by infiltrating cells such as macrophages, lymphocytes, and granulocytes.…”

Section: Discussionmentioning

confidence: 99%

The Synthesis of 18F-FDS and Its Potential Application in Molecular Imaging

Cao

et al. 2007

Mol Imaging Biol

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# These authors contributed equally to this work. AbstractPurpose-2-Deoxy-2-[ 18 F]fluoro-D-glucose (FDG) is the most commonly used positron emission tomography (PET) tracer for oncological and neurological imaging, but it has limitations on detecting tumor or inflammation in brain gray matter. In this study, we describe the development of 2-deoxy-2-[ 18 F]fluorosorbitol ( 18 F-FDS) and its possible application in lesion detection around brain area.Procedures-18 F-FDS was obtained by reduction of FDG using NaBH 4 (81±4% yield in 30 min). Cell uptake/efflux experiments in cell culture and small animal PET imaging on tumor and inflammation models were performed.Results-Despite the low accumulation in cell culture, 18 F-FDS had good tumor uptake and contrast in the subcutaneous U87MG tumor model (4.54%ID/g at 30 min post-injection). Minimal uptake in the normal mouse brain facilitated good tumor contrast in both U87MG and GL-26 orthotopic tumor models. 18 F-FDS also had increased uptake in the inflamed foci of the TPAinduced acute inflammation model.Conclusions-Because of the ease of synthesis and favorable in vivo kinetics, 18 F-FDS may have potential applications in certain cases where FDG is inadequate (e.g., brain tumor).

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“…The accumulation of 18 F-FDG in cancer tissue is thought to reflect enhanced glucose use by neoplastic cells (11)(12)(13). 18 F-FDG accumulation is observed in inflammatory lesions as well as in malignant tumors (14)(15)(16)(17). Regarding the gastrointestinal tract, 18 F-FDG PET studies have been reported in Crohn disease (18)(19)(20)(21).…”

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confidence: 99%

PET and Macro- and Microautoradiographic Studies Combined with Immunohistochemistry for Monitoring Rat Intestinal Ulceration and Healing Processes

Yamato

Kataoka²,

Mizuma³

et al. 2009

J Nucl Med

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18 F-FDG PET is used mainly in clinical settings for imaging focal cancer sites, but the usefulness of the modality in imaging gastrointestinal ulcers has not been established. We investigated whether PET can be used for noninvasive monitoring of indomethacin-induced small-intestine ulceration. Methods: Intestinal ulcers were induced in rats by subcutaneous administration of indomethacin. An 18 F-FDG PET scan was obtained at 1, 2, and 7 d after indomethacin administration. 18 F-FDG uptake in the small intestine was quantified by g-counting, and macro-and microautoradiographic studies were performed to determine the site of 18 F-FDG uptake in tissue and at the cellular level. Results: Ulcers observed in the intestine (mainly in the ileum) 1-4 d after indomethacin administration were most severe at 1 d after administration and were almost healed at day 7. The PET study showed increased 18 F-FDG uptake in the intestine correlating to the severity of ulceration, returning to the basal level on day 7. Ex vivo imaging and g-counting showed that these regions of high uptake corresponded to regions of ulceration. A microautoradiographic study combined with immunohistochemistry revealed heavy accumulation of 18 F-FDG in inflammatory cells containing peroxidase on day 1 and in cells forming granulation tissue (a-smooth muscle actin-positive myofibroblasts and ED2-positive macrophages) on days 2-4 in and around ulcers. Proliferating (Ki67-immunopositive) intestinal crypt cells were also densely labeled with 18 F-FDG in intact intestinal tissue taken from the indomethacin-treated and the control animals. Conclusion: Our experimental data suggest that 18 F-FDG PET may be useful for evaluating the occurrence of small-intestine ulcers. Ulceration could be visualized early by the prominent uptake of 18 F-FDG by inflammatory cells and by the formation of granulation tissue by cells in and around ulcers.

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Focal fluorine-18 fluorodeoxyglucose accumulation in inflammatory pancreatic disease

Cited by 146 publications

References 12 publications

Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography

Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography

The Synthesis of 18F-FDS and Its Potential Application in Molecular Imaging

PET and Macro- and Microautoradiographic Studies Combined with Immunohistochemistry for Monitoring Rat Intestinal Ulceration and Healing Processes

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