18 F-FDG PET/CT influences management in patients with known or suspected pancreatic cancer

Intern Med J. 2011 Nov;41(11):776-83. doi: 10.1111/j.1445-5994.2010.02257.x. Epub 2010 May 11.


Background: The aims of this study were (i) to assess and validate the incremental information of positron emission tomography/computed tomography (PET/CT) over conventional staging investigations (CSI) and (ii) to assess the management impact of PET/CT in patients with known or suspected pancreatic cancer.

Methods: Between October 2007 and September 2008, 22 PET/CT scans were performed using a dedicated PET/CT scanner in 21 patients with known or suspected pancreatic cancer. Follow up was used to reconcile discordance between PET/CT and CSI. The pre-PET/CT management plan and/or intent were prospectively recorded in all scans. The post-PET/CT management plan was determined from the medical record and/or discussions with treating clinicians. The management impact of PET/CT was classified as high, medium, low or none defined using Australian and New Zealand Association of Physicians in Nuclear Medicine PET data collection project criteria.

Results: PET/CT and CSI were discordant in 14/22 (64%: 95% CI; 43-84%) scans. Of the 14 discordant scans, PET/CT assessment was correct in eight, conventional imaging in four and there was insufficient information in two. Overall, PET/CT management impact was classified as high (n= 6), medium (n= 3), low (n= 9) or none (n= 4). Significant changes in management (high or medium impact) were induced by PET/CT in 9/22 scans (41%: 95% CI; 20-62%) predominantly by correctly modifying the disease extent.

Conclusion: PET/CT has an incremental benefit over CSI and has a significant impact on management in patients with known or suspected pancreatic cancer. PET/CT merits consideration as part of the non-invasive evaluation of patients with known or suspected pancreatic cancer.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease Management
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Multimodal Imaging / standards
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / therapy*
  • Positron-Emission Tomography*
  • Tomography, X-Ray Computed*


  • Fluorodeoxyglucose F18