PET/CT with Enhanced CT Perform One-Stop Shop Imaging for Assessing Pancreatic Carcinoma

Objective: To evaluate the role of PET/CT with contrast enhanced CT in diagnosing and staging for pancreatic diseases and optimize the use of enhanced PET/CT as one-stop imaging modality. Methods: Fifty-six patients who presented with suspected pancreatic carcinoma underwent whole-body F-FDG PET/CT and enhanced CT imaging. Images were interpreted and compared with the histopathology findings. The sensitivity, specificity and accuracy of enhanced CT, PET/CT and combined PET/CT with contrast enhanced CT diagnosis were analyzed. The vascular invasion and distant metastases of pancreatic lesions on different imaging modality were analyzed and compared. Results: Among the fifty-six patients evaluated for primary tumor, thirty-nine patients had malignant diseases and seventeen had benign lesions. Sensitivity, specificity and accuracy of enhanced CT were 87.5%, 75% and 83.9%, those of non-enhanced PET/CT were 89.7%, 88.2% and 89.2%, of PET/CT with enhanced CT were 100%, 94.1% and 98.2%. Combined PET/CT with enhanced CT had highest sensitivity, specificity and accuracy in diagnosing pancreatic carcinoma. Average SUVmax of malignant lesions was 6.72  3.84, compared with 2.56  1.22 for patients with benign disease (P < 0.01). Combined PET/CT with enhanced CT can help to make accurate staging especially in assessing metastases and vascular invasion. Seven patients deemed surgical candidates were changed to non-surgical treatment. SUVmax didn’t correlate with distant metastases and survival time (Pearson = −0.243, P = 0.136). Distant metastases correlate with survival time (Pearson = −0.447, P = 0.004). Conclusion: PET/CT with contrast enhanced CT is of greater value in the diagnosis of pancreatic lesions as well as preoperative staging especially in assessing vascular invasion and distant metastasis. It is feasible to perform one-stop shop imaging by combining PET/CT with enhanced CT, supplying more accurate assessment before operation and help to select optimal therapeutic plan.