caa a22 4500 475801717 CHVBK 20180406123739.0 cr unu---uuuuu 170329e20000901xx s 000 0 eng 10.1007/s002680010182 doi (NATIONALLICENCE)springer-10.1007/s002680010182 Preoperative Evaluation of Pancreatic Masses with Positron Emission Tomography Using 18F-fluorodeoxyglucose: Diagnostic Limitations [Elektronische Daten] [Andreas Sendler, Norbert Avril, Hermann Helmberger, Jens Stollfuß, Wolfgang Weber, Frank Bengel, Markus Schwaiger, Jürgen D. Roder, J. Rüdiger Siewert] Identification of pancreatic cancer in patients presenting with an enlarged pancreatic mass is a major diagnostic problem. Positron emission tomography (PET) using the radiolabeled glucose analogue 18F-fluorodeoxyglucose (FDG) has been suggested to provide excellent accuracy for noninvasive determination of suspicious pancreatic masses. We conducted a prospective study to verify these results. Forty-two patients admitted for pancreatic surgery underwent PET scanning. Image analysis was based on visual film evaluation and quantification of regional tracer uptake. PET imaging was visually analyzed by three observers blinded for the results of other diagnostic tests; they qualitatively graded the scans using a five-point scale (I = low to V = high) for the presence and intensity of focal FDG uptake. Diagnosis was proven by histology (n= 38) or follow-up (n= 4). Furthermore, the results of PET were compared with helical computed tomography (CT) and conventional ultrasonography (US), done during the routine diagnostic workup before pancreatic cancer surgery. Regarding only the results with scores of IV and V as positive for representing definite malignancy yielded a sensitivity of 71% and a specificity of 64% for film reading. Quantification of regional tracer uptake contributed no significant diagnostic advantage for differentiation between benign and malignant tumors. Helical CT revealed a sensitivity of 74% and a specificity of 45.5% and abdominal US 56% and 50%, respectively. We concluded that PET imaging provides only fair diagnostic accuracy (69%) for characterizing enlarged pancreatic masses. PET does not allow exclusion of malignant tumors. In doubtful cases, the method must be combined with other imaging modalities, such as helical CT. The results indicate that the number of invasive procedures is not significantly reduced by PET imaging. Société Internationale de Chirurgie, 2000 Sendler Andreas Department of Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut Avril Norbert Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut Helmberger Hermann Department of Diagnostic Radiology, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut Stollfuß Jens Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut Weber Wolfgang Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut Bengel Frank Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut Schwaiger Markus Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut Roder Jürgen D. Department of Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut Siewert J. Rüdiger Department of Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut World Journal of Surgery Springer-Verlag 24/9(2000-09-01), 1121-1129 0364-2313 24:9<1121 2000 24 268 https://doi.org/10.1007/s002680010182 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010182 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sendler Andreas Department of Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Avril Norbert Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Helmberger Hermann Department of Diagnostic Radiology, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Stollfuß Jens Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Weber Wolfgang Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Bengel Frank Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Schwaiger Markus Department of Nuclear Medicine, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Roder Jürgen D. Department of Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Siewert J. Rüdiger Department of Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 München, Germany aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/9(2000-09-01), 1121-1129 0364-2313 24:9<1121 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer