Incremental Role of Fluorine 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Assessment of Computed Tomography-Inconspicuous Pancreatic Lesions.

Journal of Pancreatic Cancer Pub Date : 2017-09-01 eCollection Date: 2017-01-01 DOI:10.1089/pancan.2017.0014
Fathinul Fikri Ahmad Saad, Anna Misyail Abdul Rashid, Mohamad Syafeeq Faeez Md Noh
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引用次数: 1

Abstract

Background: Pancreatic malignancies encompass a heterogenous group of disorders, with poor prognosis at diagnosis. Traditionally, conventional computed tomography (CT) has been used for diagnosis, staging, and follow up. However, this technique lacks functional information; and is limited in diagnosis of occult pancreatic disease. Hybrid imaging in the form of positron emission tomography (PET)/CT provides a potential avenue for early detection and subsequent appropriate therapy. Case Presentation: A 60-year-old male, with a history of abdominal aortic aneurysm which was repaired, came with a complaint of 2 months history of back pain, radiating to the front. The pain was relieved on leaning forward, and aggravated by lying on his back. CT angiography of the abdomen was done, which revealed a concealed aortic aneurysm and a significant atrophy of the pancreatic tail. The serum cancer antigen (CA) 19-9 was elevated (50.0 U/mL, reference range 0.0-37.0 U/mL). At this juncture, the PET scan done revealed no discernible abnormalities. Patient was put on close follow-up in view of the rising trend of CA 19-9 levels. Three months following the initial scans, a repeat 18F-FDG (fluorine 18 fluorodeoxyglucose) PET/CT revealed an FDG-avid lesion at the neck of the pancreas on PET without perceptible changes on the correlated CT. A Whipple's procedure ensued, with histopathological examination findings of pancreatic adenocarcinoma. Conclusion: This article discusses the role of PET/CT in the early diagnosis of inconspicuous pancreatic lesions; which could have averted immediate medical therapy.

Abstract Image

Abstract Image

氟- 18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在计算机断层扫描-不明显胰腺病变评估中的作用
背景:胰腺恶性肿瘤包括一组异质性疾病,诊断时预后较差。传统上,传统的计算机断层扫描(CT)已用于诊断,分期和随访。然而,这种技术缺乏功能信息;对隐匿性胰腺疾病的诊断有局限性。正电子发射断层扫描(PET)/CT形式的混合成像为早期发现和随后的适当治疗提供了潜在的途径。病例介绍:60岁男性,有腹主动脉瘤病史,已修复,主诉背部疼痛2个月,前侧放射。前倾时疼痛减轻,仰卧时疼痛加重。腹部CT血管造影显示隐藏的主动脉瘤和胰腺尾部明显萎缩。血清癌抗原(CA) 19-9升高(50.0 U/mL,参考范围0.0 ~ 37.0 U/mL)。此时,PET扫描未发现明显异常。鉴于CA 19-9水平呈上升趋势,对患者进行密切随访。首次扫描3个月后,重复18F-FDG(氟- 18氟脱氧葡萄糖)PET/CT显示胰腺颈部fdg病变,但相关CT未见明显变化。随后行惠普尔手术,组织病理学检查结果为胰腺腺癌。结论:本文探讨了PET/CT在胰腺隐性病变早期诊断中的作用;这样可以避免立即接受治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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