Is ¹⁸F‐fluorodeoxyglucose positron emission tomography meaningful for estimating the efficacy of corticosteroid therapy in patients with autoimmune pancreatitis?

Abstract

FDG-PET pattern at baseline, and a decrease in FDG uptake after a short steroid trial can be useful for discriminating AIP from PC.

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 I. Concept and diagnosis of autoimmune pancreatitis

“…The following two criteria are useful in distinguishing AIP from pancreatic cancer: extensive or multiple accumulations of FDG in the pancreas, or distinctive accumulation in extra-pancreatic lesions in the salivary gland, retroperitoneal fibrosis, or prostate gland [66,67]. Although the disappearance of FDG following steroid treatment is reported to be used as a criterion to distinguish AIP from pancreatic cancer [70], a facile steroid trial should be carefully performed after a negative work-up of malignancy, because a follow-up study of FDG-PET is not supported by Japanese medical insurance.…”

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

“…These features are useful for distinguishing between AIP and pancreatic cancer [32,103,104]. Another useful differentiating feature in AIP is a rapid decrease in FDG accumulation after corticosteroid therapy [104,105]. Description Although few studies have described EUS findings that may differentiate between AIP and pancreatic cancer or chronic pancreatitis, some findings that may be useful can be deduced from EUS or US studies of each disease [106][107][108][109][110].…”

Comparison of steroid pulse therapy and conventional oral steroid therapy as initial treatment for autoimmune pancreatitis

“…The efficacy of oral steroid therapy for AIP is well known, and the improvement of AIP in patients treated with steroids for 2 weeks can be shown in radiographic findings [5,20,36]. Our data on pancreas size after 2 weeks did not show a significant difference between oral steroid and pulse therapy.…”