Skip to main content
SpringerLink
Log in

Usefulness of FDG-PET/CT in the detection of pancreatic metastases from lung cancer

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

The objective of this study was to assess the ability to detect pancreatic metastasis of lung cancer and to clarify the degree of fluorodeoxyglucose (FDG) accumulation and computed tomography (CT) characteristics of pancreatic metastasis from lung cancer.

Methods

A total of 573 patients (415 men and 158 women) with lung cancer were retrospectively evaluated. All patients underwent FDG-positron emission tomography (PET)/CT with contrast-enhanced CT for first=stage (313 patients; initial study group) or follow-up study (260 patients; follow-up study group). A lesion was regarded as positive for metastasis on the basis of visual judgment of the degree of increased metabolism by two experienced and independent interpreters, supported by semiquantitative evaluation on the basis of calculation of the maximum standardized uptake value (SUVmax).

Results

Abnormal accumulations in the pancreas were detected in 5 of 313 patients (1.60%) in the initial study group, and 6 of 260 patients (2.31%) in the follow-up study group. Seven of these patients had adenocarcinoma, three had small cell carcinoma, and the rest had large cell endocrine carcinoma. Tumor sizes (longitudinal diameter), measured by CT, of these 11 patients ranged from 6 mm to 52 mm (mean ± SD 8.3 mm ± 11.9 mm), and SUVmax for 1 h ranged from 3.37 to 11.1 (mean ± SD 6.12 ± 2.43). Three of these pancreatic lesions were difficult to determine by routine transaxial images, and detection was obvious only by thin-slice images or multiplanar reconstruction images. Contrast-enhanced CT showed gradual fill-in from the peripheral portion to the center. In addition, 10 of 11 cases did not show main pancreatic duct dilatation even if the tumor size was large.

Conclusions

Metastases to the pancreas in lung cancer patients are not so rare and radiologists first have an important role to detect the pancreatic mass and then suggest to metastasis as the likely diagnosis. For this purpose, FDG-PET/CT has an advantage in depicting unsuspected pancreatic metastasis from lung cancer, particularly that which is not detected by CT alone.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Rumancik WM, Megihow AJ, Bosniak MA, Hilton S. Metastatic disease to the pancreas: evaluation by computed tomography. J Comput Assist Tomogr 1984;8:829–834.

    Article  PubMed  CAS  Google Scholar 

  2. Klein KA, Stephens DH, Welch TJ. CT characteristics of metastatic disease of the pancreas. Radiographics 1998;18:369–378.

    PubMed  CAS  Google Scholar 

  3. Ferrozzi F, Bova D, Campodonico F, Chiara FD, Passari A, Bassi P. Pancreatic metastasis: CT assessment. Eur Radiol 1997;7:241–245.

    Article  PubMed  CAS  Google Scholar 

  4. Scatarige JC, Horton KM, Sheth S, Fishman EK. Pancreatic parenchymal metastases: observations on helical CT. AJR Am J Roentgenol 2001;176:695–699.

    PubMed  CAS  Google Scholar 

  5. Merkle EM, Boaz T, Kolokythas O, Haaga JR, Lewin JS, Brambs HJ. Metastases to the pancreas. Br J Radiol 1998;71:1208–1214.

    PubMed  CAS  Google Scholar 

  6. Maeno T, Satoh H, Ishikawa H, Yamashita YT, Naito T, Fujiwara M, et al. Patterns of pancreatic metastasis from lung cancer. Anticancer Res 1998;18:2881–2884.

    PubMed  CAS  Google Scholar 

  7. García Viadl C, Carrillo E, Barreiro B. Solitary metastasis to the pancreas in a patient with lung cancer. Arch Bronconerumol 2003;39:601.

    Article  Google Scholar 

  8. Liratzopoulos N, Efremidou EI, Papageorgiou MS, Romanidis K, Minopoulos GGJ, Manolas J. Extrahepatic biliary obstruction due to a solitary pancreatic metastasis of squamous cell lung carcinoma: case report. J Gastrointest Liver Dis 2006;15:73–75.

    Google Scholar 

  9. Johnson DH, Hainsworth JD, Greco FA. Extrahepatic biliary obstruction caused by small-cell lung cancer. Ann Intern Med 1985;102:487–490.

    PubMed  CAS  Google Scholar 

  10. Chowhan NM, Madajewicz S. Management of metastasesinduced acute pancreatitis in small cell carcinoma of the lung. Cancer 1990;65:1445–1448.

    Article  PubMed  CAS  Google Scholar 

  11. Kim KH, Kim CD, Lee SJ, Lee G, Jean YT, Lee SC, et al. Metastasis-induced acute pancreatitis in a patient with small cell carcinoma of the lung. J Korean Med Sci 1999;14:107–109.

    PubMed  CAS  Google Scholar 

  12. Lowe J, Naunheim S. Current role of positron emission tomography in thoracic oncology. Thorax 1998;53:703–712.

    PubMed  CAS  Google Scholar 

  13. Gambihir S, Czernin J, Schwimmer J, Silverman DHS, Coleman RE, Phelps ME. A tabulated summary to the FDG PET literature. J Nucl Med 2001;42:1S–71S.

    Google Scholar 

  14. Towensend DW, Camey IPJ, Yap JT, Hall NC. PET/CT today and tomorrow. J Nucl Med; 45:4S–14S.

  15. Schoder H, Gonen M. Screening for cancer with PET and PET/CT: potential and limitations. J Nucl Med 2007;48:4S–18S.

    Article  PubMed  CAS  Google Scholar 

  16. Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, et al. Staging of non-small-cell lung cancer with integrated positron emission tomography and computed tomography. New Engl J Med 2003;348:2500–2507.

    Article  PubMed  Google Scholar 

  17. Antoch C, Stattaus J, Nemat AT, Mamitz AT, Beyer T, Kuehl H, et al. Non small cell lung cancer dual-modality PET/CT in preoperative staging. Radiology 2003;229:526–533.

    Article  PubMed  Google Scholar 

  18. Shim SS, Lee LS, Kim BT, Chung MJ, Lee EJ, Han J, et al. Non small cell lung cancer preoperative comparison of integrated FDG PET/CT and CT alone for preoperative staging. Radiology 2005;236:1101–1109.

    Article  Google Scholar 

  19. Seki M, Tsuchita E, Hori M, Nakagawa K, Ohta H, Ueno M, et al. Pancreatic metastasis from a lung cancer. Int J Pancreatol 1998;24:55–59.

    PubMed  CAS  Google Scholar 

  20. Muranaka T, Teshima K, Honda H, Nanjo T, Hanada K, Oshiumi Y. Computed tomography and histologic appearance of pancreatic metastases from distant source. Acta Radiol 1989;30:615–619.

    Article  PubMed  CAS  Google Scholar 

  21. Higashi T, Saga T, Nakamoto Y, Ishimori T, Fujimoto K, Doi R, et al. Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET): usefulness and limitations in “clinical reality”. Ann Nucl Med 2003;17:261–279.

    Article  PubMed  Google Scholar 

  22. Nakamoto Y, Higashi T, Sakahara H, Tamaki N, Itoh K, Iimura M, et al. Evaluation of pancreatic islet cell tumors by fluorine-18 fluorodeoxyglucose positron emission tomography; comparison with other modalities. Clin Nucl Med 2002;25:115–119.

    Article  Google Scholar 

  23. Nakamoto Y, Saga T, Ishimori T, Higashi T, Mamede M, Okazaki K, et al. FDG-PET of autoimmune-related pancreatitis: preliminary results. Eur J Nucl Med 2000;27:1835–1838.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Ibaraki Prefectural Central Hospital, 6528 Koibuchi, Kasama, Ibaraki, 309-1793, Japan

    Motohiro Sato, Toshiyuki Okumura & Keiko Kaito

  2. Department of Surgery, Ibaraki Prefectural Central Hospital, Ibaraki, Japan

    Moriyuki Kiyoshima, Yuji Asato & Ryuta Amemiya

  3. Department of Internal Medicine, Ibaraki Prefectural Central Hospital, Ibaraki, Japan

    Keiko Uchiumi, Hiroaki Iijima, Ikuta Hashimoto & Takayuki Kaburagi

Authors
  1. Motohiro Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshiyuki Okumura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keiko Kaito
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Moriyuki Kiyoshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuji Asato
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Keiko Uchiumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroaki Iijima
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ikuta Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Takayuki Kaburagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ryuta Amemiya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Motohiro Sato.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sato, M., Okumura, T., Kaito, K. et al. Usefulness of FDG-PET/CT in the detection of pancreatic metastases from lung cancer. Ann Nucl Med 23, 49–57 (2009). https://doi.org/10.1007/s12149-008-0205-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-008-0205-5

Keywords

Search

Navigation