Positron emission tomography with 2-deoxy-2-[ 18 F] fluoro-d-glucose for diagnosis of intraductal papillary mucinous tumor of the pancreas with parenchymal invasion

Abstract

We used positron emission tomography with 2-deoxy-2-[(18)F]fluoro- d-glucose (FDG-PET) in the diagnosis of two cases of malignant intraductal papillary mucinous tumor (IPMT) of the pancreas. A 56-year-old man and a 72-year-old man, both with tumors in the pancreatic head, were referred to Akita University Medical Center. Computed tomography revealed tumors with multiple cystic components in both patients. FDG-PET images showed markedly high FDG uptake in the area corresponding to a solid component found in one patient and diffuse faint uptake, higher than that of the surrounding tissue, in the other patient, who had no solid component. Histological examination of the resected specimens after pancreatectomy showed invasive carcinoma involving the pancreatic parenchyma in both patients. Although our experience is limited and preliminary, FDG-PET seems to be useful for the detection of malignancy in IPMT, especially in patients not showing any solid component on conventional diagnostic images such as computed tomography.

Additional value of FDG PET/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms of the pancreas with mural nodules

“…Several case reports have shown that an increased FDG uptake was observed in the mural nodules of malignant IPMN [15,16]. Baiocchi et al [17] have reported MRCP and PET findings of 7 patients with IPMN (2 malignant and 5 benign).…”

F-18-fluorodeoxyglucose positron emission tomography in differentiating malignant from benign pancreatic cysts: a prospective study

“…To our knowledge there are few reports dealing with PET imaging and cystic diseases of the pancreas. Yoshioka et al 28 reported a high 18-FDG uptake in two patients with IPMT and invasive carcinoma. On the other hand, McHenry et al 29 found that EUS fine-needle aspiration was more accurate (71%) than PET scan (50%) in detecting malignant cystic lesions.…”

Pancreatobiliary and pancreatoduodenal fistulae in intraductal papillary mucinous neoplasm of the pancreas: Report of a case

“…However, recent reports have suggested that 18 F-fl uorodeoxyglucose positron emission tomography is more accurate than conventional imaging techniques (CT and magnetic resonance imaging) in distinguishing between the two. 11,12 In general, IPMN can be classifi ed into mainduct IPMN and side-branch IPMN based on imaging studies and histology. Main-duct and side-branch IPMN have signifi cant differences in their prevalence of cancer, thus this classifi cation has prognostic implications.…”