Although the detection of
pancreatic carcinoma has been considerably improved by recently developed imaging procedures, differential diagnosis between
cancer and benign
tumor masses, as well as lymph node staging, is still difficult. In vivo evaluation of regional
glucose metabolism by means of positron emission tomography (PET) and fluorine-18-labelled fluorode-oxyglucose (FDG) is a new approach utilizing metabolic instead of morphological
tumor properties for diagnosis. PATIENTS AND METHODS. A total of 85 patients with suspected
pancreatic carcinoma were investigated by FDG-PET prior to surgery. Static PET scans were evaluated visually as well as quantitatively, taking increased FDG uptake as a sign of
malignancy. PET results were correlated with intraoperative findings and histopathology of surgical specimens. RESULTS. Forty-seven out of 55 (85%) malignant
tumors and 23 out of 30 (77%) benign lesions were correctly classified by PET.
Lymph node metastases were present in 31 patients, 19 of them (61%) positive in PET. In 7 our of 13 (54%) patients with liver
metastases, PET detected hypermetabolic lesions. False-negative findings were mainly due to disturbance of
glucose metabolism in diabetic patients, while most false-positive results could be attributed to acute inflammatory lesions in
chronic pancreatitis. CONCLUSIONS. Our results indicate that classification of pancreatic masses can be improved by use of FDG-PET, which might lead to a reduction of unnecessary
laparotomies in patients with benign or incurable disease.