The Role of PET Scanning in Pancreatic Cancer

  • M. Fernandez-Ulloa
Part of the M. D. Anderson Solid Tumor Oncology Series book series (MDA)

For many years computed tomography (CT) has been the principal imaging modality used for diagnosis and staging of patients with pancreatic cancer. Currently, contrast enhanced multidetector CT (ce MDCT), remains the most commonly used imaging study in the initial evaluation of these patients. Depending on clinical practices and preferences, other modalities, such as magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS), are also utilized in the diagnosis and staging of pancreatic carcinoma (1, 2).

The use of positron emission tomography (PET) in routine oncology practice has accelerated significantly in the past decade. Oncologic PET imaging is mainly performed with F18-FDG (FDG), a glucose analog that accumulates in cancer cells. This modality is under investigation in the evaluation of patients with pancreatic carcinoma as a diagnostic tool to better define extent of disease and guide treatment. Specifically, the ability of FDG-PET to find metastasis to the liver and elsewhere may be of great value in the management of patients with pancreatic cancer.


Positron Emission Tomography Pancreatic Cancer Chronic Pancreatitis Pancreatic Carcinoma Positron Emission Tomography Scan 
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  1. 1.
    McMahon PM, Halpern EF, Fernandez-del Castillo C, 2001, Pancreatic cancer: cost-effectiveness of imaging technologies for assessing resectability. Radiology 221:93–106.CrossRefPubMedGoogle Scholar
  2. 2.
    Launois B, Stasik C, Bardaxoglou E, 1999, Who benefits from portal vein resection during pancreaticoduodenectomy for pancreatic cancer? World J Surg 23:926–929.CrossRefPubMedGoogle Scholar
  3. 3.
    Abe Y, Matsuzawa T, Fujiwara T, 1986, Assessment of radiotherapeutic effects on experimental tumors using F-18-2-fluoro-2-deoxy-D-glucose. Eur J Nucl Med 12: 325–328.CrossRefPubMedGoogle Scholar
  4. 4.
    Higashi T, Tamaki N, Honda T, 1997, Expression of glucose transporters in human pancreatic tumors compared with increased F-18 FDG accumulation in PET study. J Nucl Med 38:1337–1344.PubMedGoogle Scholar
  5. 5.
    Reske S, Grillenberger KG, Glatting G, 1997, Overexpression of glucose transporter 1 and increased F-18 FDG uptake in pancreatic carcinoma. J Nucl Med 38: 1344–1348.Flier JS, Mueckler MM, Usher P, 1987, Elevated levels of glucose transport and transporter messenger RNA are induced by ras or src oncogenes. Science 235:1492-1495.PubMedGoogle Scholar
  6. 6.
    Brix G, Lechel U, Glatting G, 2005, (Federal Office for Radiation Protection, Neuherberg, Germany; Univ of Ulm, Germany; Technical Univ, Munich; et al.) Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J Nucl Med 46:608–613.PubMedGoogle Scholar
  7. 7.
    Stollfuss JC, Glatting G, Friess H, 1995, 2-(fluorine-18)-fluoro-2-deoxy-D-glucose PET in detection of pancreatic cancer: value of quantitative image interpretation. Radiology 195:339–344.PubMedGoogle Scholar
  8. 8.
    Koyama K, Okamura T, Kawabe J, 2001, Diagnostic usefulness of FDG PET for pancreatic mass lesions. Ann Nucl Med 15: 217–24.CrossRefPubMedGoogle Scholar
  9. 9.
    Zimny M, Bares R, Fass J, 1997, Fluorine-18 fluorodeoxyglucose positron emission tomography in the differential diagnosis of pancreatic carcinoma: a report of 106 cases. Eur J Nucl Med 24:678–682.PubMedGoogle Scholar
  10. 10.
    Nehmeh SA, Ford E, Rosenzweig K, 2001, Gated positron emission tomography: a technique for reducing lung tumor motion effect. J Nucl Med 42:34P–34P.Google Scholar
  11. 11.
    Goerres GW, Ziegler SI, Burger C, 2003, Artifacts at PET and PET/CT caused by metallic hip prosthetic material. Radiology 226:577–584.CrossRefPubMedGoogle Scholar
  12. 12.
    Wahl RL, Cody RL, Hutchins GD, 1991, Primary and metastatic breast carcinoma: initial clinical evaluation with PET with the radiolabeled glucose analogue 2-(F-18)-fluoro-2-deoxy-D-glucose. Radiology 179:765–770.PubMedGoogle Scholar
  13. 13.
    Langen KJ, Braun U, Rota Kops E, 1993, The influence of plasma glucose levels on fluorine-18-fluorodeoxyglucose uptake in bronchial carcinomas. J Nucl Med 34: 355–359.PubMedGoogle Scholar
  14. 14.
    Lindholm P, Minn H, Leskinen-Kallio S, 1993, Influence of the blood glucose concentration on FDG uptake in cancer: a PET study. J Nucl Med 34:1–6.PubMedGoogle Scholar
  15. 15.
    Bakkevold KE, Amesjo B, Kambestad B. 1992, Carcinoma of the pancreas and papilla of vater-assessment of respectability and factors influencing respectability in stage I carcinoma. A prospective multicentre trial in 472 patients. Eur J Surg Oncol 18: 494–507.PubMedGoogle Scholar
  16. 16.
    Zimny M, Schumpelick V, 2001, (Fluorodeoxyglucose positron emission tomography (FDG-PET) in the differential diagnosis of pancreatic lesions). Chirurgie 72:989–994.CrossRefGoogle Scholar
  17. 17.
    Inokuma T, Tamaki N, Torizuka T, 1995, Evaluation of pancreatic tumors with positron emis-sion tomography and F-18 fluorodeoxyglucose: comparison with CT and US. Radiology 195:345–352.PubMedGoogle Scholar
  18. 18.
    Sperti C, Pasquali C, Decet G, 2005, F-18-fluorodeoxyglucose positron emission tomography in differentiating malignant from benign pancreatic cysts: a prospective study. J Gastrointest Surg 9:22–29.CrossRefPubMedGoogle Scholar
  19. 19.
    Berberat P, Friess H, Kashiwagi M, 1999, Diagnosis and staging of pancreatic cancer by positron emission tomography. World J Surg 23:882–887.CrossRefPubMedGoogle Scholar
  20. 20.
    Gambhir SS, Czernin J, Schwimmer J, 2001, A tabulated summary of the FDG PET literature. J. Nucl Med 42:1S–93S.PubMedGoogle Scholar
  21. 21.
    Lemke AJ, Nieheus SM, Hosten N, 2004, Retrospective digital image fusion of multidetector CT and 18 F-FDG PET: clinical value in pancreatic lesions—a prospective study with 104 patients. J Nucl Med 45 (8): 1279–1286.PubMedGoogle Scholar
  22. 22.
    Heinrich S, Goerres GW, Schafer M, 2005, Positron emission tomography/computed tomography influences on the management of resectable pancreatic cancer and its cost-effectiveness. Ann Surg 242(2):235–243.CrossRefPubMedGoogle Scholar
  23. 23.
    Bares R, Klever P, Hauptmann S, 1994, F-18 fluorodeoxyglucose PET in vivo evaluation of pancreatic glucose metabolism for detection of pancreatic cancer. Radiology 192: 79–86.PubMedGoogle Scholar
  24. 24.
    Diederichs CG, Staib L, Vogel J, 2000, Values and limitations of 18F-fluorodeoxyglucose-positron-emission tomography with preoperative evaluation of patients with pancreatic masses. Pancreas 20:109–116.CrossRefPubMedGoogle Scholar
  25. 25.
    Higashi T, Saga T, Nakamoto Y, 2003, Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET): usefulness and limitations in “clinical reality”. Ann Nucl Med 17:261–279.CrossRefPubMedGoogle Scholar
  26. 26.
    Frohlich A, Diederichs CG, Staib L, 1999, Detection of liver metastases from pancreatic can-cer using FDG PET. J Nucl Med 40:250–255.PubMedGoogle Scholar
  27. 27.
    Nakamoto Y, Higashi T, Sakahara H, 1999, Contribution of PET in the detection of liver metastases from pancreatic tumours. Clin Radiol 54:248–252.CrossRefPubMedGoogle Scholar
  28. 28.
    Teffey SA, Hildeboldt CC, Dehashti F, 2003, Detection of primary hepatic malignancy in liver transplant candidates: prospective comparison of CT, MR imaging, US and PET. Radiology 226:533–542.CrossRefGoogle Scholar
  29. 29.
    Nishiyama Y, Yamamoto Y, Yokoe K, 2005, Contribution of whole body FDG-PET to the detection of distant metastasis in pancreatic cancer. Ann Nucl Med 19:491–497.CrossRefPubMedGoogle Scholar
  30. 30.
    Rose DM, Delbeke D, Beauchamp RD, 1999, 18-Fluorodeoxyglucose-positron emission tomography ( 18 FDG-PET) in the management of patients with suspected pancreatic cancer. Ann Surg 229:729–738.CrossRefPubMedGoogle Scholar
  31. 31.
    Delbeke D, Rose DM, Chapman WC, 1999, Optimal interpretation of FDG PET in the diagnosis, stating and management of pancreatic carcinoma. J Nucl Med 40(11):1784–1791.PubMedGoogle Scholar
  32. 32.
    Orlando LA, Kulasingam SL, Matchar DB. 2004; Meta-analysis the detection of pancreatic malignancy with positron emission tomography. Aliment Pharmacol Ther 20:1063–1070.CrossRefPubMedGoogle Scholar
  33. 33.
    Higashi T, Sakahara H. Torizuka T, 1999, Evaluation of intraoperative radiation therapy for unresectable pancreatic cancer with FDG PET. J Nucl Med 40: 1424–1433.PubMedGoogle Scholar
  34. 34.
    Maisey NR, Webb A, Flux GD, 2000, FDG PET in the prediction of survival of patients with cancer of the pancreas: a pilot study. Br J Cancer 83:287–293.CrossRefPubMedGoogle Scholar
  35. 35.
    Franke C, Klapdor R, Meyerhoff K, 1999, 18 F-positron emission tomography of the pancreas: diagnostic benefit in the follow-up of pancreatic carcinoma. Anticancer Res 19: 2437–2442.PubMedGoogle Scholar
  36. 36.
    Nakata B, Chung YS, Nishimura S, 1997, 18 F-fluorodeoxyglucose positron emission tomography and the prognosis of patients with pancreatic carcinoma. Cancer 79:695–699.CrossRefPubMedGoogle Scholar
  37. 37.
    Zimny M, Fass J, Bares R, 2000, Fluorodeoxyglucose positron emission tomography and the prognosis of pancreatic carcinoma. Scand J Gastroenterol 35:883–888.CrossRefPubMedGoogle Scholar
  38. 38.
    Sperti C, Pasquali C, Chierichetti F, 2003, 18-Fluorodeoxyglucose positron emission tomog-raphy in predicting survival of patients with pancreatic carcinoma. J Gastrointest Surg 7:953–960.CrossRefPubMedGoogle Scholar
  39. 39.
    Lyshchik A, Higashi T, Nakamoto Y, 2005, Dual-phase 18F-fluoro-2-deoxy-D-glucose positron emission tomography as prognostic parameter in patients with pancreatic cancer. Eur J Nucl Med 33:389–397.CrossRefGoogle Scholar

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© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • M. Fernandez-Ulloa
    • 1
  1. 1.University of Cincinnati College of MedicineCincinnatiUSA

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