Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography
Background Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely used for the diagnosis of pancreatic cancer. Because autoimmune pancreatitis is easily misdiagnosed as pancreatic cancer and can be tested for by FDG-PET analysis based on the presence of suspected pancr...
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Veröffentlicht in: | Journal of gastroenterology 2008-02, Vol.43 (2), p.144-151 |
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creator | Ozaki, Yayoi Oguchi, Kazuhiro Hamano, Hideaki Arakura, Norikazu Muraki, Takashi Kiyosawa, Kendo Momose, Mitsuhiro Kadoya, Masumi Miyata, Kazunobu Aizawa, Takao Kawa, Shigeyuki |
description | Background
Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely used for the diagnosis of pancreatic cancer. Because autoimmune pancreatitis is easily misdiagnosed as pancreatic cancer and can be tested for by FDG-PET analysis based on the presence of suspected pancreatic cancer, we attempted to clarify the differences in FDG-PET findings between the two conditions.
Methods
We compared FDG-PET findings between 15 patients with autoimmune pancreatitis and 26 patients with pancreatic cancer. The findings were evaluated visually or semiquantitatively using the maximum standardized uptake value and the accumulation pattern of FDG.
Results
FDG uptake was found in all 15 patients with autoimmune pancreatitis, whereas it was found in 19 of 26 patients (73.1%) with pancreatic cancer. An accumulation pattern characterized by nodular shapes was significantly more frequent in pancreatic cancer, whereas a longitudinal shape indicated autoimmune pancreatitis. Heterogeneous accumulation was found in almost all cases of autoimmune pancreatitis, whereas homogeneous accumulation was found in pancreatic cancer. Significantly more cases of pancreatic cancer showed solitary localization, whereas multiple localization in the pancreas favored the presence of autoimmune pancreatitis. FDG uptake by the hilar lymph node was significantly more frequent in autoimmune pancreatitis than in pancreatic cancer, and uptake by the lachrymal gland, salivary gland, biliary duct, retroperitoneal space, and prostate were seen only in autoimmune pancreatitis.
Conclusions
FDG-PET is a useful tool for differentiating autoimmune pancreatitis from suspected pancreatic cancer, if the accumulation pattern and extrapancreatic involvement are considered. IgG4 measurement and other current image tests can further confirm the diagnosis. |
doi_str_mv | 10.1007/s00535-007-2132-y |
format | Article |
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Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely used for the diagnosis of pancreatic cancer. Because autoimmune pancreatitis is easily misdiagnosed as pancreatic cancer and can be tested for by FDG-PET analysis based on the presence of suspected pancreatic cancer, we attempted to clarify the differences in FDG-PET findings between the two conditions.
Methods
We compared FDG-PET findings between 15 patients with autoimmune pancreatitis and 26 patients with pancreatic cancer. The findings were evaluated visually or semiquantitatively using the maximum standardized uptake value and the accumulation pattern of FDG.
Results
FDG uptake was found in all 15 patients with autoimmune pancreatitis, whereas it was found in 19 of 26 patients (73.1%) with pancreatic cancer. An accumulation pattern characterized by nodular shapes was significantly more frequent in pancreatic cancer, whereas a longitudinal shape indicated autoimmune pancreatitis. Heterogeneous accumulation was found in almost all cases of autoimmune pancreatitis, whereas homogeneous accumulation was found in pancreatic cancer. Significantly more cases of pancreatic cancer showed solitary localization, whereas multiple localization in the pancreas favored the presence of autoimmune pancreatitis. FDG uptake by the hilar lymph node was significantly more frequent in autoimmune pancreatitis than in pancreatic cancer, and uptake by the lachrymal gland, salivary gland, biliary duct, retroperitoneal space, and prostate were seen only in autoimmune pancreatitis.
Conclusions
FDG-PET is a useful tool for differentiating autoimmune pancreatitis from suspected pancreatic cancer, if the accumulation pattern and extrapancreatic involvement are considered. IgG4 measurement and other current image tests can further confirm the diagnosis.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-007-2132-y</identifier><identifier>PMID: 18306988</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Abdominal Surgery ; Adenocarcinoma - diagnostic imaging ; Adult ; Aged ; Autoimmune Diseases - diagnosis ; Biliary Tract ; Colorectal Surgery ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18 ; Gastroenterology ; Hepatology ; Humans ; Liver ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Pancreas ; Pancreatic cancer ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatitis - diagnostic imaging ; Pancreatitis - immunology ; Positron-Emission Tomography ; Radiopharmaceuticals ; Surgical Oncology</subject><ispartof>Journal of gastroenterology, 2008-02, Vol.43 (2), p.144-151</ispartof><rights>Springer Japan 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c532t-7a351463e9bd91987ba9c84b5f725d5e39f66ecdd83803ff35160918c5dfce373</citedby><cites>FETCH-LOGICAL-c532t-7a351463e9bd91987ba9c84b5f725d5e39f66ecdd83803ff35160918c5dfce373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-007-2132-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-007-2132-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18306988$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ozaki, Yayoi</creatorcontrib><creatorcontrib>Oguchi, Kazuhiro</creatorcontrib><creatorcontrib>Hamano, Hideaki</creatorcontrib><creatorcontrib>Arakura, Norikazu</creatorcontrib><creatorcontrib>Muraki, Takashi</creatorcontrib><creatorcontrib>Kiyosawa, Kendo</creatorcontrib><creatorcontrib>Momose, Mitsuhiro</creatorcontrib><creatorcontrib>Kadoya, Masumi</creatorcontrib><creatorcontrib>Miyata, Kazunobu</creatorcontrib><creatorcontrib>Aizawa, Takao</creatorcontrib><creatorcontrib>Kawa, Shigeyuki</creatorcontrib><title>Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely used for the diagnosis of pancreatic cancer. Because autoimmune pancreatitis is easily misdiagnosed as pancreatic cancer and can be tested for by FDG-PET analysis based on the presence of suspected pancreatic cancer, we attempted to clarify the differences in FDG-PET findings between the two conditions.
Methods
We compared FDG-PET findings between 15 patients with autoimmune pancreatitis and 26 patients with pancreatic cancer. The findings were evaluated visually or semiquantitatively using the maximum standardized uptake value and the accumulation pattern of FDG.
Results
FDG uptake was found in all 15 patients with autoimmune pancreatitis, whereas it was found in 19 of 26 patients (73.1%) with pancreatic cancer. An accumulation pattern characterized by nodular shapes was significantly more frequent in pancreatic cancer, whereas a longitudinal shape indicated autoimmune pancreatitis. Heterogeneous accumulation was found in almost all cases of autoimmune pancreatitis, whereas homogeneous accumulation was found in pancreatic cancer. Significantly more cases of pancreatic cancer showed solitary localization, whereas multiple localization in the pancreas favored the presence of autoimmune pancreatitis. FDG uptake by the hilar lymph node was significantly more frequent in autoimmune pancreatitis than in pancreatic cancer, and uptake by the lachrymal gland, salivary gland, biliary duct, retroperitoneal space, and prostate were seen only in autoimmune pancreatitis.
Conclusions
FDG-PET is a useful tool for differentiating autoimmune pancreatitis from suspected pancreatic cancer, if the accumulation pattern and extrapancreatic involvement are considered. IgG4 measurement and other current image tests can further confirm the diagnosis.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adult</subject><subject>Aged</subject><subject>Autoimmune Diseases - diagnosis</subject><subject>Biliary Tract</subject><subject>Colorectal Surgery</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Liver</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatitis - diagnostic imaging</subject><subject>Pancreatitis - immunology</subject><subject>Positron-Emission Tomography</subject><subject>Radiopharmaceuticals</subject><subject>Surgical Oncology</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1UU2r1TAUDKL4rld_gBspLtxVc5qmTZby_HgPHrjRdUjTk2sebVPzAfYv-KvNpRcuCK4yZObMHM4Q8hroe6C0_xAp5YzXBdYNsKbenpADtOWHy6Z5Sg5Utm0N0Lc35EWMj5QCo1w8JzcgGO2kEAfy55OzFgMuyenk_FJ5W-mcvJvnvGC16sUELExysbLBz1XMcUWTcLxypjIFYqiGrbJT9sEtWIPYsR_R_95OUzY-Fj8fXQolBmcX4zkv-dmfgl5_bi_JM6uniK8u75H8-PL5--1d_fDt6_3tx4facNakuteMQ9sxlMMoQYp-0NKIduC2b_jIkUnbdWjGUTBBmbVF3VEJwvDRGmQ9O5J3u-8a_K-MMamyi8Fp0gv6HFVPGadQLnskb_8RPvoclrKbaqCHjresLSLYRSb4GANatQY367ApoOrcktpbUmd4bkltZebNxTgPM47XiUstRdDsglio5YThmvx_179h76Fs</recordid><startdate>200802</startdate><enddate>200802</enddate><creator>Ozaki, Yayoi</creator><creator>Oguchi, Kazuhiro</creator><creator>Hamano, Hideaki</creator><creator>Arakura, Norikazu</creator><creator>Muraki, Takashi</creator><creator>Kiyosawa, Kendo</creator><creator>Momose, Mitsuhiro</creator><creator>Kadoya, Masumi</creator><creator>Miyata, Kazunobu</creator><creator>Aizawa, Takao</creator><creator>Kawa, Shigeyuki</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>200802</creationdate><title>Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography</title><author>Ozaki, Yayoi ; Oguchi, Kazuhiro ; Hamano, Hideaki ; Arakura, Norikazu ; Muraki, Takashi ; Kiyosawa, Kendo ; Momose, Mitsuhiro ; Kadoya, Masumi ; Miyata, Kazunobu ; Aizawa, Takao ; Kawa, Shigeyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-7a351463e9bd91987ba9c84b5f725d5e39f66ecdd83803ff35160918c5dfce373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Adult</topic><topic>Aged</topic><topic>Autoimmune Diseases - diagnosis</topic><topic>Biliary Tract</topic><topic>Colorectal Surgery</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Liver</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Pancreas</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatitis - diagnostic imaging</topic><topic>Pancreatitis - immunology</topic><topic>Positron-Emission Tomography</topic><topic>Radiopharmaceuticals</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ozaki, Yayoi</creatorcontrib><creatorcontrib>Oguchi, Kazuhiro</creatorcontrib><creatorcontrib>Hamano, Hideaki</creatorcontrib><creatorcontrib>Arakura, Norikazu</creatorcontrib><creatorcontrib>Muraki, Takashi</creatorcontrib><creatorcontrib>Kiyosawa, Kendo</creatorcontrib><creatorcontrib>Momose, Mitsuhiro</creatorcontrib><creatorcontrib>Kadoya, Masumi</creatorcontrib><creatorcontrib>Miyata, Kazunobu</creatorcontrib><creatorcontrib>Aizawa, Takao</creatorcontrib><creatorcontrib>Kawa, Shigeyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ozaki, Yayoi</au><au>Oguchi, Kazuhiro</au><au>Hamano, Hideaki</au><au>Arakura, Norikazu</au><au>Muraki, Takashi</au><au>Kiyosawa, Kendo</au><au>Momose, Mitsuhiro</au><au>Kadoya, Masumi</au><au>Miyata, Kazunobu</au><au>Aizawa, Takao</au><au>Kawa, Shigeyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2008-02</date><risdate>2008</risdate><volume>43</volume><issue>2</issue><spage>144</spage><epage>151</epage><pages>144-151</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Background
Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been widely used for the diagnosis of pancreatic cancer. Because autoimmune pancreatitis is easily misdiagnosed as pancreatic cancer and can be tested for by FDG-PET analysis based on the presence of suspected pancreatic cancer, we attempted to clarify the differences in FDG-PET findings between the two conditions.
Methods
We compared FDG-PET findings between 15 patients with autoimmune pancreatitis and 26 patients with pancreatic cancer. The findings were evaluated visually or semiquantitatively using the maximum standardized uptake value and the accumulation pattern of FDG.
Results
FDG uptake was found in all 15 patients with autoimmune pancreatitis, whereas it was found in 19 of 26 patients (73.1%) with pancreatic cancer. An accumulation pattern characterized by nodular shapes was significantly more frequent in pancreatic cancer, whereas a longitudinal shape indicated autoimmune pancreatitis. Heterogeneous accumulation was found in almost all cases of autoimmune pancreatitis, whereas homogeneous accumulation was found in pancreatic cancer. Significantly more cases of pancreatic cancer showed solitary localization, whereas multiple localization in the pancreas favored the presence of autoimmune pancreatitis. FDG uptake by the hilar lymph node was significantly more frequent in autoimmune pancreatitis than in pancreatic cancer, and uptake by the lachrymal gland, salivary gland, biliary duct, retroperitoneal space, and prostate were seen only in autoimmune pancreatitis.
Conclusions
FDG-PET is a useful tool for differentiating autoimmune pancreatitis from suspected pancreatic cancer, if the accumulation pattern and extrapancreatic involvement are considered. IgG4 measurement and other current image tests can further confirm the diagnosis.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>18306988</pmid><doi>10.1007/s00535-007-2132-y</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Abdominal Surgery Adenocarcinoma - diagnostic imaging Adult Aged Autoimmune Diseases - diagnosis Biliary Tract Colorectal Surgery Diagnosis, Differential Female Fluorodeoxyglucose F18 Gastroenterology Hepatology Humans Liver Male Medicine Medicine & Public Health Middle Aged Pancreas Pancreatic cancer Pancreatic Neoplasms - diagnostic imaging Pancreatitis - diagnostic imaging Pancreatitis - immunology Positron-Emission Tomography Radiopharmaceuticals Surgical Oncology |
title | Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography |
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