Usefulness of 18-FDG PET/CT in detecting malignancy in intraductal papillary mucinous neoplasms of the pancreas

Abstract

Background/Aim: Identifying malignancy in intraductal papillary mucinous neoplasm (IPMN) of the pancreas remains challenging. This study aimed to evaluate the usefulness of 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT) in distinguishing malignant from benign IPMN of the pancreas. Patients and Methods: The cases of 79 patients with IPMN of the pancreas who underwent surgical resections between 1996 and 2016 at our Institution were enrolled in the present retrospective analysis of predictors for malignancy in IPMN of the pancreas. 18-FDG PET/CT evaluations were performed in 38 patients, and the usefulness of 18-FDG PET/CT for detecting malignancy in IPMN of the pancreas was evaluated. Results: Three factors were significantly related to malignancy in IPMN; the diameter of the main pancreatic duct, the serum value of carcinoembryonic antigen (CEA), and the neutrophil–to–lymphocyte ratio (NLR). 18-FDG PET accumulation was significantly related to malignancy in IPMN; sensitivity 0.82 and specificity 0.71. Independent predictors for malignancy in IPMN were as follows: 18-FDG PET accumulation, CEA >1.0 ng/ml, and NLR >2.63. Conclusion: 18-FDG PET accumulation is a potent new marker for distinguishing malignant from benign IPMNs of the pancreas.