Clinical usefulness of fluorodeoxyglucose-positron emission tomography/computed tomography and carbohydrate antigen 19-9 in patients with periampullary tumors

Periampullary tumors can arise from structures near the ampulla of Vater, pancreas, common bile duct, or duodenum, and the prognosis varies with the origin [1]. These neoplasms are usually treated by pylorus-preserving pancreatoduodenectomy or Whipple procedure. Pancreas cancer is one of most aggressive malignancies and cancers involving the pancreas are the fifth most common cause of cancer deaths in Korea [2]. Early diagnosis and differentiation of malignant from benign periampullary neoplasm is essential for decisions on performing surgical resection. The initial work up for a patient with periampullary masses includes computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), and magnetic resonance cholangiopancreatography (MRCP) [3]. FNA is important in the diagnosis of cystic lesions of the pancreas, but EUS-FNA of pancreatic tumors is dif cult to perform because of the retroperitoneal location [4,5]. Invasive procedures like endoscopic retrograde cholangiopancreatography (ERCP) or EUS-FNA have diagnostic accuracy, but are associated with procedure-related complications [6]. FDG-PET/ Original Article Korean Journal of Clinical Oncology 2019;15:56-60 https://doi.org/10.14216/kjco.19011 pISSN 1738-8082 ∙ eISSN 2288-4084