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Is 18 F‐fluorodeoxyglucose positron emission tomography meaningful for estimating the efficacy of corticosteroid therapy in patients with autoimmune pancreatitis?
Author(s) -
Shigekawa Minoru,
Yamao Kenji,
Sawaki Akira,
Hara Kazuo,
Takagi Tadayuki,
Bhatia Vikram,
Nishio Masami,
Tamaki Tsuneo,
ElAmin Hussein,
Sayed Zain ELAbdeen Ahmed,
Mizuno Nobumasa
Publication year - 2010
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-009-0172-9
Subject(s) - autoimmune pancreatitis , positron emission tomography , fluorodeoxyglucose , medicine , nuclear medicine , pancreatitis , corticosteroid , standardized uptake value , pancreatic cancer , pancreas , gastroenterology , cancer
Background Autoimmune pancreatitis (AIP) is often misdiagnosed as pancreatic cancer (PC). Both conditions accumulate 18 F‐fluorodeoxyglucose (FDG), so FDG positron emission tomography (FDG‐PET) is not discriminatory. This study aimed to evaluate the pattern of FDG accumulation, and the change in FDG uptake after steroid treatment in AIP and PC. Methods We compared FDG‐PET patterns between 18 patients with AIP and 20 patients with PC, and also evaluated the short‐term changes in FDG uptake after steroid therapy. Results FDG uptake was observed in 88.9% in AIP and 90.0% in PC. FDG uptake in extra‐abdominal lymph nodes was seen more frequently in AIP, and uptake in salivary glands, eyes and biliary ducts was seen only in AIP. Follow‐up PET was performed in 6 AIP patients and in 3 PC patients. Changes in SUV max after steroid therapy were estimated within 1 week in 5 AIP patients and in all 3 PC patients, retrospectively. In 4 AIP patients, the change in SUV max was more than 10%. On the other hand, in PC, SUV max increased or remained almost unchanged (within 10%). Conclusions FDG‐PET pattern at baseline, and a decrease in FDG uptake after a short steroid trial can be useful for discriminating AIP from PC.