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The Clinical Usefulness of 18-Fluorodeoxyglucose Positron Emission Tomography in the Differential Diagnosis, Staging, and Response Evaluation After Concurrent Chemoradiotherapy for Pancreatic Cancer

Bang, Seungmin MD*; Chung, Hye Won MD*; Park, Seung Woo MD* †; Chung, Jae Bock MD*; Yun, Mijin MD; Lee, Jong Doo MD; Song, Si Young MD, PhD* †

Journal of Clinical Gastroenterology: November-December 2006 - Volume 40 - Issue 10 - p 923-929
doi: 10.1097/01.mcg.0000225672.68852.05
Liver, Pancreas, and Biliary Tract: Clinical Research

Goals The aims of this study were to determine the clinical use of 18-fluorodeoxyglucose positron emission tomography (18FDG-PET) in the differential diagnosis of patients with suspected pancreatic cancer and in the determination of tumor response after concurrent chemoradiotherapy for pancreatic cancer.

Background Despite advances in diagnostic tools for pancreatic cancer, it is difficult to differentiate pancreatic cancer from mass-forming pancreatitis. Even with current imaging modalities, it is also difficult to assess tumor response to therapeutic intervention.

Study One hundred two patients with suspected pancreatic cancer were selected for this study. Dynamic computerized tomography (CT) scan and 18FDG-PET were used sequentially to diagnose pancreatic cancer. After diagnostic confirmation their diagnostic yields were compared. We also evaluated the treatment response in 15 patients who underwent chemoradiation therapy with dynamic CT scan and 18FDG-PET and compared their results.

Results In 93 out of 102 patients, pancreatic cancer was confirmed. 18FDG-PET showed higher diagnostic accuracy than CT scan (95.1% vs. 76.5%). 18FDG-PET was also superior to CT in the detection of liver metastasis. 18FDG-PET detected treatment response in 5 out of 15 cases after chemoradiation therapy, whereas CT could not detect any treatment response. Comparing responder and nonresponder, 18FDG-PET was able to predict significantly different prognosis (399 vs. 233 d, P<0.05).

Conclusions 18FDG-PET is a very useful tool in diagnosing pancreatic cancer. 18FDG-PET may be also used as an adjunct for determining the treatment modality of pancreatic cancer and evaluating tumor response to chemoradiation therapy.

*Department of Internal Medicine, Division of Gastroenterology, Institute of Gastroenterology

Brain Korea 21 Project for Medical Science

Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea

Reprints: Si Young Song, MD, PhD, Department of Internal Medicine, Yonsei University College of Medicine, Shinchon-dong 134, Seodaemoon-gu, Seoul, 120-752, Korea (e-mail:

Received for publication December 8, 2005; accepted June 26, 2006

© 2006 Lippincott Williams & Wilkins, Inc.