The Role of Positron Emission Tomography in the Management of Pancreatic Cancer

Pakzad, Farrokh; Groves, Ashley M.; Ell, Peter J.

doi:10.1053/j.semnuclmed.2006.03.005

Cited by 127 publications

(77 citation statements)

References 42 publications

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“…Our previous report demonstrated that initial stages using CT scan were changed in 26.9% patients with pancreatic cancer after PET scan (Bang et al, 2006a). Positron emission tomography scans showed high sensitivity and specificity in detecting metastatic disease, including liver, lungs, and peritoneum (Pakzad et al, 2006;Bang et al, 2006a). Initial staging workup, including PET scans, might be beneficial in selecting good candidates for chemoradiotherapy in locally advanced pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

Weekly full-dose gemcitabine and single-dose cisplatin with concurrent radiotherapy in patients with locally advanced pancreatic cancer

et al. 2008

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The aim of this study was to evaluate the efficacy and the toxicity of a full dose of gemcitabine and a single dose of cisplatin with concurrent radiotherapy in patients with locally advanced pancreatic cancer. Forty-one patients with locally advanced pancreatic cancer were enrolled. Patients received gemcitabine (1000 mg m À2 on days 1, 8, 15, 29, and 36) and cisplatin (70 mg m À2 on days 1 and 29) with concurrent radiotherapy (45 Gy in 25 fractions). Treatment was completed in 38 out of 41 patients (92.7%). The overall response rate was 24.4% (two complete and eight partial). Six patients (14.6%) underwent definite pancreatic resection and four had negative surgical margins. The intention of the treatment analysis showed that the median survival time and median time to tumour progression were 16.7 and 8.9 months. The 1-and 2-year survival rates were 63.3 and 27.9%, respectively. Overall survival was significantly longer in the low baseline CA19-9 group and therapeutic responders. Toxicities were tolerable and successfully managed by conservative treatments. The therapeutic scheme of a weekly full dose of gemcitabine and a single dose of cisplatin combined with external radiation is effective and might prolong the survival of patients with locally advanced pancreatic cancer.

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Section: Discussionmentioning

confidence: 99%

Weekly full-dose gemcitabine and single-dose cisplatin with concurrent radiotherapy in patients with locally advanced pancreatic cancer

et al. 2008

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“…Surgery remains the only potential for long-ter m sur vival, with a resectability rate of around 15%-20% in the latest review [1] . Even in patients with resectable disease, the 5-year survival rate is still around 20% [1][2][3] . For patients with unresectable disease, chemotherapy with or without radiation therapy is usually chosen, and the survival benefit of chemotherapy with Gemcitabine over 5-fluorouracil has recently been reported [4] .…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the advantages of positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) on diagnosing pancreatic cancer, especially small lesions less than 2 cm in size, over the conventional modalities, including computed tomography (CT), have been reported [2] . Further more, FDG-PET has also been reported to possibly play a role in predicting the prognosis of pancreatic cancer [2,5,6] .…”

Section: Introductionmentioning

confidence: 99%

Role of 18F-fluorodeoxyglucose positron emission tomography imaging in surgery for pancreatic cancer

Wakabayashi¹,

Nishiyama²,

Otani³

et al. 2008

WJG

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AIM:To evaluate the role of positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) in the surgical management of patients with pancreatic cancer, including the diagnosis, staging, and selection of patients for the subsequent surgical treatment. METHODS:This study involved 53 patients with proven primary pancreatic cancer. The sensitivity of diagnosing the primary cancer was examined for FDG-PET, CT, cytological examination of the bile or pancreatic juice, and the serum levels of carcinoembrionic antigens (CEA) and carbohydrate antigen 19-9 (CA19-9). Next, the accuracy of staging was compared between FDG-PET and CT. Finally, FDG-PET was analyzed semiquantitatively using the standard uptake value (SUV). The impact of the SUV on patient management was evaluated by examining the correlations between the SUV and the histological findings of cancer. RESULTS:The sensitivity of FDG-PET, CT, cytological examination of the bile or pancreatic juice, and the serum levels of CEA and CA19-9 were 92.5%, 88.7%, 46.4%, 37.7% and 69.8%, respectively. In staging, FDG-PET was superior to CT only in diagnosing distant disease (bone metastasis). For local staging, the sensitivity of CT was better than that of FDG-PET. The SUV did not correlate with the pTNM stage, grades, invasions to the vessels and nerve, or with the size of the tumor. However, there was a statistically significant difference (4.6 ± 2.9 vs 7.8 ± 4.5, P = 0.024) in the SUV between patients with respectable and unresectable disease.CONCLUSION: FDG-PET is thus considered to be useful in the diagnosis of pancreatic cancer. However, regarding the staging of the disease, FDG-PET is not considered to be a sufficiently accurate diagnostic modality. Although the SUV does not correlate with the patho-histological prognostic factors, it may be useful in selecting patients who should undergo subsequent surgical treatment.

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“…In a study of 135 subjects using tumor markers CA19-9 and CEA to detect PC, CA19-9 and CEA were shown to have a sensitivity of 80% and 40%, with a specificity of 67.5% and 73%, respectively [5,6] . Despite developments in MRI and ultrasound, CT remains the modality of choice for the diagnosis, staging, and restaging of PC with an accuracy of 69-94%, and an accuracy of 63-95% in the detection of recurrence [5,[7][8][9] . This data was based upon tumors greater than 2.0 cm; therefore the accuracy of anatomic modalities in the detection of small lesions has yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

FDG PET/CT detected an insidious inguinal canal metastasis in a patient with pancreatic cancer

Ong

Yıldız

Kostakoğlu

2012

JBGC

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A 70 year old male with a history of inoperable pancreatic cancer with peritoneal metastases was evaluated by FDG PET/CT imaging for disease extent and therapy response after 4 cycles of chemotherapy. PET/CT demonstrated mildly increased uptake at the primary site within the pancreatic neck and in the peritoneum. An unexpected finding involved increased uptake in the right inguinal canal region around the patient's known hernia. A hernia inflammation was suspected and the patient subsequently underwent surgical intervention for possible strangulation. Unexpectedly, the histopathologic evaluation of the surgical specimen revealed peritoneal metastasis in the inguinal canal. Although metastasis to this localization is rather rare, the use of PET/CT assisted in the discovery of unexpected metastasis in a rare location.

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The Role of Positron Emission Tomography in the Management of Pancreatic Cancer

Cited by 127 publications

References 42 publications

Weekly full-dose gemcitabine and single-dose cisplatin with concurrent radiotherapy in patients with locally advanced pancreatic cancer

Weekly full-dose gemcitabine and single-dose cisplatin with concurrent radiotherapy in patients with locally advanced pancreatic cancer

Role of 18F-fluorodeoxyglucose positron emission tomography imaging in surgery for pancreatic cancer

FDG PET/CT detected an insidious inguinal canal metastasis in a patient with pancreatic cancer

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