A prospective study of the impact of fluorodeoxyglucose positron emission tomography with concurrent non-contrast CT scanning on the management of operable pancreatic and peri-ampullary cancers

Burge, Matthew E., O'Rourke, Nick, Cavallucci, David, Bryant, Richard, Francesconi, Alessandra, Houston, Kathleen, Wyld, David, Eastgate, Melissa, Finch, Robert, Hopkins, George, Thomas, Paul and Macfarlane, David (2015) A prospective study of the impact of fluorodeoxyglucose positron emission tomography with concurrent non-contrast CT scanning on the management of operable pancreatic and peri-ampullary cancers. HPB, 17 7: 624-631. doi:10.1111/hpb.12418

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Author Burge, Matthew E.
O'Rourke, Nick
Cavallucci, David
Bryant, Richard
Francesconi, Alessandra
Houston, Kathleen
Wyld, David
Eastgate, Melissa
Finch, Robert
Hopkins, George
Thomas, Paul
Macfarlane, David
Title A prospective study of the impact of fluorodeoxyglucose positron emission tomography with concurrent non-contrast CT scanning on the management of operable pancreatic and peri-ampullary cancers
Journal name HPB   Check publisher's open access policy
ISSN 1477-2574
Publication date 2015-07-01
Sub-type Article (original research)
DOI 10.1111/hpb.12418
Open Access Status DOI
Volume 17
Issue 7
Start page 624
End page 631
Total pages 8
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2016
Formatted abstract
Background: The role of fluorodeoxyglucose (FDG) positron emission tomography (PET/CT) scanning in operable pancreas cancer is unclear. We, therefore, wanted to investigate the impact of PET/CT on management, by incorporating it into routine work-up.

Methods: This was a single-institution prospective study. Patients with suspected and potentially operable pancreas, distal bile duct or ampullary carcinomas underwent PET/CT in addition to routine work-up. The frequency that PET/CT changed the treatment plan or prompted other investigations was determined. The distribution of standard uptake values (SUV) among primary tumours, and adjacent to biliary stents was characterised.

Results: Fifty-six patients were recruited. The surgical plan was abandoned in 9 (16%; 95% CI: 6-26) patients as a result of PET/CT identified metastases. In four patients, metastases were missed and seven were inoperable at surgery, not predicted by PET/CT. Unexpected FDG uptake resulted in seven additional investigations, of which two were useful. Among primary pancreatic cancers, a median SUV was 4.9 (range 2-12.1). SUV was highest around the biliary stent in 17 out of 28 cases. PET/CT detected metastases in five patients whose primary pancreatic tumours demonstrated mild to moderate avidity (SUV < 5).

Conclusions: PET/CT in potentially operable pancreas cancer has limitations. However, as a result of its ability to detect metastases, PET/CT scanning is a useful tool in the selection of such patients for surgery.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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Created: Wed, 26 Aug 2015, 09:52:30 EST by Anthony Yeates on behalf of Examinations