18-FDG positron emission tomography of the pancreas: diagnostic benefit in the follow-up of pancreatic carcinoma.

UNLABELLED: The aim of this prospective study was to determine the role of FDG-PET in the follow up care of patients with pancreatic carcinoma in comparison with sonography, computed tomography and tumour marker levels. 19 patients were investigated, 9 patients with non-resectable tumour disease and 10 patients after resection of primary tumor. We found corresponding results in 15/19 patients, but in 2 patients additional metastases were detected. In another 5 patients of this group, PET results decisively influenced the further therapeutic procedure. In 2/19 patients only PET showed viable tumour tissue, in spite of negative findings in CT and sonography. In 2/19 patients we found false negative results with PET. One patient had increased blood glucose levels at the time of investigation, the other one was investigated shortly after locoregional chemotherapy. Compared to CA 19-9, PET investigation may also result in positive findings, in spite of non elevated CA 19-9 serum levels.

CONCLUSION: PET has been shown as an effective tool also in the follow up care of patients with pancreatic cancer. In more than half of the patients PET offered important additional information to clinicians, resulting in a change of the therapeutic procedure. Especially before locoregional chemotherapy or in case of increased tumor marker levels without morphological substrate in US/CT PET with FDG seems to represent a valuable investigation.