Correlative CT and FDG PET Imaging in Pancreatic Malignancy

Aim T to evaluate the role of 18F-FDG PET (collimated gamma camera) and CT in patients with suspected pancreatic malignancy. Methods Preoperative scans from 81 patients (56 male, 25 female, age range 34–82 years) were included for comparison. Scan findings were recorded as being malignant, non-malignant or equivocal. The presence or absence of metastases was also recorded. In addition to the routine clinical report all scans were re-reported for this study. Results CT and PET findings were concordant in 46 patients, discordant in 31 patients. Both studies were equivocal in 4 cases. Out of the 46 concordant cases, both CT and PET were positive for malignancy in 35 cases, both were negative in 11 cases. Among the discordant cases, CT was positive with PET negative in 7 cases and PET was positive with CT negative in 4 cases. In 19 cases where the diagnosis was equivocal on CT scan, PET scan was positive for malignancy in 10 cases and negative for malignancy in 9. In 1 patient who had an equivocal PET scan the CT scan was positive for malignancy. Clinical correlation using histology and clinical follow-up data to determine sensitivity and specificity is under way. Conclusion Our provisional results indicate that there is a useful role for FDG PET scanning along with CT scanning. Although our study involved gamma camera PET we found that the results were clinically useful in the absence of access to dedicated PET scan services.