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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 7/2011

01-08-2011 | Original article

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

Authors: Kentaro Takanami, Tomomichi Hiraide, Masashi Tsuda, Yasuhiro Nakamura, Tomohiro Kaneta, Kei Takase, Hiroshi Fukuda, Shoki Takahashi

Published in: Annals of Nuclear Medicine | Issue 7/2011

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Abstract

Objectives

This study aimed at determining the additional value of FDG PET/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms (IPMNs) of the pancreas with mural nodules.

Methods

This retrospective review of medical records was approved by our institutional review board. The preoperative PET/CT images of 16 non-diabetic patients with surgically proven IPMN, where mural nodules of 3 mm or larger were shown by preoperative contrast-enhanced CT, were retrospectively evaluated. The 16 patients were divided into two groups: 7 patients with benign IPMN [adenoma (n = 1) and borderline tumor (n = 6)] and 9 patients with malignant IPMN [carcinoma in situ (CIS) (n = 8) and invasive carcinoma (n = 1)]. Nuclear medicine physician blinded to the pathologic assessment of malignancy of IPMN set a spherical volume of interest (VOI) over the mural nodules on PET/CT images and recorded the peak standardized uptake value (SUVmax) in the VOI, referring the contrast-enhanced CT images. Statistical differences in the size of mural nodule, the diameter of main pancreatic duct (MPD), and SUVmax of the tumors between benign IPMNs and malignant IPMNs were compared using the Mann–Whitney U test. Statistical significance was set at p < 0.05. Additionally, the diagnostic accuracy of FDG PET for the detection of malignancy was calculated.

Results

The SUVmax of the malignant IPMNs with mural nodules of 3 mm or larger was higher than that of benign IPMNs (2.7 ± 0.6 vs. 1.9 ± 0.3, p < 0.01). Meanwhile, there was no significant difference in mural nodule diameter and MPD diameter between the two groups. FDG PET/CT showed an excellent diagnostic accuracy for the differentiation between malignant and benign IPMNs with mural nodules: the sensitivity, specificity, PPV, NPV, and accuracy in malignant IPMN with mural nodule of FDG PET/CT were 77.8, 100, 100, 77.8, and 87.5 for the cutoff value of 2.3; and 100, 57.1, 75.0, 100, and 81.3 for the cutoff value of 2.0, respectively.

Conclusions

The result of this study indicates that FDG PET/CT can provide additional information for the differentiation between benign and malignant IPMNs of the pancreas with mural nodules.
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Metadata
Title
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
Authors
Kentaro Takanami
Tomomichi Hiraide
Masashi Tsuda
Yasuhiro Nakamura
Tomohiro Kaneta
Kei Takase
Hiroshi Fukuda
Shoki Takahashi
Publication date
01-08-2011
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 7/2011
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-011-0494-y

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