Yoneyana et al in their
study that was published in the EuropeanJournal of Radiology report on the accuracy of contrast-enhanced (CE)
18F-fluorodeoxyglucose (FDG)–positron emission tomography (PET)/computed
tomography (CT) in the staging of pancreatic cancer.
A total of 95 patients
with primary pancreatic cancer underwent 18F-FDG PET/CT examinations. The diagnostic accuracy between non-CE PET/CT
and CE PET/CT was compared using as a reference standard histology in 48 patients
(51%) and an obvious progression in number or size of the lesions on follow-up
CT examinations in 47 patients (49%).
Invasion of duodenum (n = 20,
21%), mesentery (n = 12, 13%), and retroperitoneum (n = 13, 14%)
was correctly diagnosed by both modalities.
The diagnostic accuracy of nodal metastases of the two modalities was
similar with metastases correctly diagnosed by CE PET/CT in 38 patients (88%)
and by non-CE PET/CT in 45 patients (87%). Using CE PET/CT, distant metastases,
scalene node metastasis, and peritoneal dissemination were correctly diagnosed
in 39 patients (91%), while interpretation based on non-CE PET/CT revealed
distant metastasis, scalene node metastasis, and peritoneal dissemination in 42
patients (81%). Therefore, the diagnostic
accuracy of CE PET/CT was significantly higher than that of non-CE PET/CT (p < 0.05)
in distant metastases, scalene node metastasis, and peritoneal dissemination.
The authors concluded that
the addition of contrast in PET/CT studies allows for a more precise assessment
of distant metastases, scalene node metastases, and peritoneal dissemination in
patients with pancreatic cancer.
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