{"title":"2. FDG-PET在惠普尔手术后疑似复发胰腺癌患者临床诊断中的应用","authors":"Jadvar H, Fischman AJ","doi":"10.1016/S1095-0397(00)00068-6","DOIUrl":null,"url":null,"abstract":"<div><p><strong>Purpose:</strong> We evaluated the usefulness of FDG-PET in the assessment of patients with suspected pancreatic carcinoma who have previously undergone a Whipple procedure.</p><p><strong>Methods and Materials:</strong> Attenuation-corrected FDG-PET was performed in 11 patients (5 males, 6 females, age range 52–76 years), with suspected recurrent pancreatic carcinoma after Whipple procedure. Recurrence was suspected based on clinical, laboratory (CA19-9 serum tumor marker level), or abdominal CT findings. Diagnostic validation was by histology in 2 patients and radiologic or clinical follow-up (5 to 48 months) in 9 patients. Changes in therapeutic management that were prompted by PET were tabulated.</p><p><strong>Results:</strong> PET was concordant with the findings of abdominal CT in 7 patients (6 true-positive, 1 true-negative). PET detected unsuspected lung lesions in 1 of these patients that was subsequently confirmed by a chest CT. PET was discordant with abdominal CT in 4 patients. PET detected tumor recurrence in 3 of 4 patients in this group (27% of total) who had non-diagnostic CT and elevated CA19-9 serology. Chemotherapy was initiated in 2 of these 3 patients (18% of total), while the other patient died shortly after the PET study from pneumonia and recurrent tumor was confirmed at autopsy. The remaining 1 of 4 patients in the discordant group had a false-positive PET study due to relatively high FDG localization in a displaced loop of bowel.</p><p><strong>Conclusion:</strong> PET is useful in localizing the tumor in post-Whipple patients with suspected recurrent pancreatic carcinoma and can impact their clinical management.</p></div>","PeriodicalId":80267,"journal":{"name":"Clinical positron imaging : official journal of the Institute for Clinical P.E.T","volume":"3 4","pages":"Page 156"},"PeriodicalIF":0.0000,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1095-0397(00)00068-6","citationCount":"6","resultStr":"{\"title\":\"2. Diagnostic Utility of FDG-PET in the Clinical Management of Patients with Suspected Recurrent Pancreatic Carcinoma after Whipple Procedure\",\"authors\":\"Jadvar H, Fischman AJ\",\"doi\":\"10.1016/S1095-0397(00)00068-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p><strong>Purpose:</strong> We evaluated the usefulness of FDG-PET in the assessment of patients with suspected pancreatic carcinoma who have previously undergone a Whipple procedure.</p><p><strong>Methods and Materials:</strong> Attenuation-corrected FDG-PET was performed in 11 patients (5 males, 6 females, age range 52–76 years), with suspected recurrent pancreatic carcinoma after Whipple procedure. Recurrence was suspected based on clinical, laboratory (CA19-9 serum tumor marker level), or abdominal CT findings. Diagnostic validation was by histology in 2 patients and radiologic or clinical follow-up (5 to 48 months) in 9 patients. Changes in therapeutic management that were prompted by PET were tabulated.</p><p><strong>Results:</strong> PET was concordant with the findings of abdominal CT in 7 patients (6 true-positive, 1 true-negative). PET detected unsuspected lung lesions in 1 of these patients that was subsequently confirmed by a chest CT. PET was discordant with abdominal CT in 4 patients. PET detected tumor recurrence in 3 of 4 patients in this group (27% of total) who had non-diagnostic CT and elevated CA19-9 serology. Chemotherapy was initiated in 2 of these 3 patients (18% of total), while the other patient died shortly after the PET study from pneumonia and recurrent tumor was confirmed at autopsy. The remaining 1 of 4 patients in the discordant group had a false-positive PET study due to relatively high FDG localization in a displaced loop of bowel.</p><p><strong>Conclusion:</strong> PET is useful in localizing the tumor in post-Whipple patients with suspected recurrent pancreatic carcinoma and can impact their clinical management.</p></div>\",\"PeriodicalId\":80267,\"journal\":{\"name\":\"Clinical positron imaging : official journal of the Institute for Clinical P.E.T\",\"volume\":\"3 4\",\"pages\":\"Page 156\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2000-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/S1095-0397(00)00068-6\",\"citationCount\":\"6\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical positron imaging : official journal of the Institute for Clinical P.E.T\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1095039700000686\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical positron imaging : official journal of the Institute for Clinical P.E.T","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1095039700000686","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
2. Diagnostic Utility of FDG-PET in the Clinical Management of Patients with Suspected Recurrent Pancreatic Carcinoma after Whipple Procedure
Purpose: We evaluated the usefulness of FDG-PET in the assessment of patients with suspected pancreatic carcinoma who have previously undergone a Whipple procedure.
Methods and Materials: Attenuation-corrected FDG-PET was performed in 11 patients (5 males, 6 females, age range 52–76 years), with suspected recurrent pancreatic carcinoma after Whipple procedure. Recurrence was suspected based on clinical, laboratory (CA19-9 serum tumor marker level), or abdominal CT findings. Diagnostic validation was by histology in 2 patients and radiologic or clinical follow-up (5 to 48 months) in 9 patients. Changes in therapeutic management that were prompted by PET were tabulated.
Results: PET was concordant with the findings of abdominal CT in 7 patients (6 true-positive, 1 true-negative). PET detected unsuspected lung lesions in 1 of these patients that was subsequently confirmed by a chest CT. PET was discordant with abdominal CT in 4 patients. PET detected tumor recurrence in 3 of 4 patients in this group (27% of total) who had non-diagnostic CT and elevated CA19-9 serology. Chemotherapy was initiated in 2 of these 3 patients (18% of total), while the other patient died shortly after the PET study from pneumonia and recurrent tumor was confirmed at autopsy. The remaining 1 of 4 patients in the discordant group had a false-positive PET study due to relatively high FDG localization in a displaced loop of bowel.
Conclusion: PET is useful in localizing the tumor in post-Whipple patients with suspected recurrent pancreatic carcinoma and can impact their clinical management.