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Zentralbl Chir 2003; 128(5): 375-378
DOI: 10.1055/s-2003-40030
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© Georg Thieme Verlag Stuttgart · New York

Die Wertigkeit der Fluordeoxyglukose Positronenemissionstomographie (FDG-PET) in der Diagnostik von Pankreasprozessen

The value of fluorodeoxyglucose positron emission tomography (FDG-PET) in differentiation of pancreatic lesionsM. Voth1 , T. Opfermann1 , D. Gottschild1
  • 1Universitätsklinikum der Friedrich-Schiller-Universität, Klinik für Radiologie, Abteilung für Nuklearmedizin, Jena
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Publication History

Publication Date:
18 June 2003 (online)

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Zusammenfassung

In der onkologischen Diagnostik nutzt das funktionsbildgebende Verfahren der Positronenemissionstomographie mit F-18-Fluorodeoxyglukose (FDG-PET) den zumeist erhöhten Zuckerstoffwechsel bei malignen Prozessen im Vergleich zu nicht maligne verändertem Gewebe. Diese kurze Übersicht beschreibt die Grundlagen der FDG-PET und gibt einen Überblick über die Wertigkeit in der Diagnostik von Pankreasprozessen. Die Sicherheit in der Differenzierung von entzündlichen Prozessen und dem Pankreaskarzinom kann durch eine dynamische Akquisition der Pankreasläsion erhöht werden.

Abstract

Fluorine-18 fluordeoxyglucose positron emission tomography (FDG-PET) is a functional imaging modality that is based on the metabolic activity wich is higher in most malignant tumors than benign tissues. This short review describes the basics of FDG-PET and gives a discussion of its role in differentiation of focal pancreatic lesions. The diagnostic accuracy in patients with active inflammation or cancer of the pancreas can be improved by dynamic acquisition of focal pancreatic lesions.

Schlüsselwörter

FDG-PET - Positronenemissionstomographie - Pankreaskarzinom

Key words

FDG-PET - Positron emission tomography - Pancreatic cancer - Glucose metabolism

Literatur

  • 1 Bakkevold K E, Kambestad B. Long-term survival following radical and palliative treatment of patients with carcinoma of the pancreas and papilla of Vater - the prognostic factors influencing the long-term results. A prospective multicentre study.  Eur J Surg Oncol. 1993;  19 (2) 147-161
    PubMedSearch in Google Scholar
  • 2 Bares R, Dohmen B M, Cremerius U, Fass J, Teusch M, Büll U. [Results of positron emission tomography with fluorine-18 labeled fluorodeoxyglucose in differential diagnosis and staging of pancreatic carcinoma].  Radiologe. 1996;  36 (5) 435-440
    CrossrefPubMedSearch in Google Scholar
  • 3 Bares R, Klever P, Hauptmann S, Hellwig D, Fass J, Cremerius U, Schumpelick V, Mittermayer C, Büll U. F-18 fluorodeoxyglucose PET in vivo evaluation of pancreatic glucose metabolism for detection of pancreatic cancer.  Radiology. 1994;  192 (1) 79-86
    CrossrefPubMedSearch in Google Scholar
  • 4 Delbeke D, Rose D M, Chapman W C, Pinson C W, Wright J K, Beauchamp R D, Shyr Y, Leach S D. Optimal interpretation of FDG PET in the diagnosis, staging and management of pancreatic carcinoma.  J Nucl Med. 1999;  40 (11) 1784-1791
    PubMedSearch in Google Scholar
  • 5 Diederichs C G, Staib L, Glatting G, Beger H G, Reske S N. FDG PET: elevated plasma glucose reduces both uptake and detection rate of pancreatic malignancies.  J Nucl Med. 1998;  39 (6) 1030-1033
    PubMedSearch in Google Scholar
  • 6 Diederichs C G, Staib L, Vogel J, Glasbrenner B, Glatting G, Brambs H J, Beger H G, Reske S N. Values and limitations of 18F-fluorodeoxyglucose-positron-emission tomography with preoperative evaluation of patients with pancreatic masses.  Pancreas. 2000;  20 (2) 109-116
    PubMedSearch in Google Scholar
  • 7 Engel H, Steinert H, Buck A, Berthold T, Huch Boni R A, von Schulthess G K. Whole-body PET: physiological and artifactual fluorodeoxyglucose accumulations.  J Nucl Med. 1996;  37 (3) 441-446
    PubMedSearch in Google Scholar
  • 8 Friess H, Langhans J, Ebert M, Beger H G, Stollfuss J, Reske S N, Buchler M W. Diagnosis of pancreatic cancer by 2[18F]-fluoro-2-deoxy-D-glucose positron emission tomography.  Gut. 1995;  36 (5) 771-777
    PubMedSearch in Google Scholar
  • 9 Fröhlich A, Diederichs C G, Staib L, Vogel J, Beger H G, Reske S N. Detection of liver metastases from pancreatic cancer using FDG PET.  J Nucl Med. 1999;  40 (2) 250-255
    PubMedSearch in Google Scholar
  • 10 Haberkorn U, Ziegler S I, Oberdorfer F, Trojan H, Haag D, Peschke P, Berger M R, Altmann A, van Kaick G. FDG uptake, tumor proliferation and expression of glycolysis associated genes in animal tumor models.  Nucl Med Biol. 1994;  21 (6) 827-834
    PubMedSearch in Google Scholar
  • 11 Ho C L, Dehdashti F, Griffeth L K, Buse P E, Balfe D M, Siegel B A. FDG-PET evaluation of indeterminate pancreatic masses.  J Comput Assist Tomogr. 1996;  20 (3) 363-369
    CrossrefPubMedSearch in Google Scholar
  • 12 Hoh C K, Hawkins R A, Glaspy J A, Dahlbom M, Tse N Y, Hoffman E J, Schiepers C, Choi Y, Rege S, Nitzsche E. et al . Cancer detection with whole-body PET using 2-[18F]fluoro-2-deoxy-D-glucose.  J Comput Assist Tomogr. 1993;  17 (4) 582-589
    PubMedSearch in Google Scholar
  • 13 Inokuma T, Tamaki N, Torizuka T, Magata Y, Fujii M, Yonekura Y, Kajiyama T, Ohshio G, Imamura M, Konishi J. Evaluation of pancreatic tumors with positron emission tomography and F-18 fluorodeoxyglucose: comparison with CT and US.  Radiology. 1995;  195 (2) 345-352
    PubMedSearch in Google Scholar
  • 14 Jadvar H, Fischman A J. Evaluation of pancreatic carcinoma with FDG PET.  Abdom Imaging. 2001;  26 (3) 254-259
    CrossrefPubMedSearch in Google Scholar
  • 15 Kato T, Fukatsu H, Ito K, Tadokoro M, Ota T, Ikeda M, Isomura T, Ito S, Nishino M, Ishigaki T. Fluorodeoxyglucose positron emission tomography in pancreatic cancer: an unsolved problem.  Eur J Nucl Med. 1995;  22 (1) 32-39
    PubMedSearch in Google Scholar
  • 16 Keogan M T, Tyler D, Clark L, Branch M S, McDermott V G, DeLong D M, Coleman R E. Diagnosis of pancreatic carcinoma: role of FDG PET.  AJR Am J Roentgenol. 1998;  171 (6) 1565-1570
    PubMedSearch in Google Scholar
  • 17 Klever P, Bares R, Fass J, Büll U, Schumpelick V. PET with fluorine-18 deoxyglucose for pancreatic disease.  Lancet. 1992;  340 (8828) 1158-1159
    CrossrefPubMedSearch in Google Scholar
  • 18 Nakamoto Y, Higashi T, Sakahara H, Tamaki N, Kogire M, Doi R, Hosotani R, Imamura M, Konishi J. Delayed (18)F-fluoro-2-deoxy-D-glucose positron emission tomography scan for differentiation between malignant and benign lesions in the pancreas.  Cancer. 2000;  89 (12) 2547-2554
    CrossrefPubMedSearch in Google Scholar
  • 19 Nitzsche E U, Hoegerle S, Mix M, Brink I, Otte A, Moser E, Imdahl A. Non-invasive differentiation of pancreatic lesions: is analysis of FDG kinetics superior to semiquantitative uptake value analysis?.  Eur J Nucl Med Mol Imaging. 2002;  29 (2) 237-242
    CrossrefPubMedSearch in Google Scholar
  • 20 Reske S N, Grillenberger K G, Glatting G, Port M, Hildebrandt M, Gansauge F, Beger H G. Overexpression of glucose transporter 1 and increased FDG uptake in pancreatic carcinoma.  J Nucl Med. 1997;  38 (9) 1344-1348
    PubMedSearch in Google Scholar
  • 21 Reske S N, Kotzerke J. FDG-PET for clinical use. Results of the 3rd German Interdisciplinary Consensus Conference, “Onko-PET III”, 21 July and 19 September 2000.  Eur J Nucl Med. 2001;  28 (11) 1707-1723
    Search in Google Scholar
  • 22 Schek N, Hall B L, Finn O J. Increased glyceraldehyde-3-phosphate dehydrogenase gene expression in human pancreatic adenocarcinoma.  Cancer Res. 1988;  48 (22) 6354-6359
    PubMedSearch in Google Scholar
  • 23 Schober O, Lottes G. [Positron emission tomography and radiation exposure].  Nuklearmedizin. 1994;  33 (5) 174-177
    PubMedSearch in Google Scholar
  • 24 Shreve P D. Focal fluorine-18 fluorodeoxyglucose accumulation in inflammatory pancreatic disease.  Eur J Nucl Med. 1998;  25 (3) 259-264
    CrossrefPubMedSearch in Google Scholar
  • 25 Stollfuss J C, Glatting G, Friess H, Kocher F, Berger H G, Reske S N. 2-(fluorine-18)-fluoro-2-deoxy-D-glucose PET in detection of pancreatic cancer: value of quantitative image interpretation.  Radiology. 1995;  195 (2) 339-344
    PubMedSearch in Google Scholar
  • 26 van Gulik T M, Moojen T M, van Geenen R, Rauws E A, Obertop H, Gouma D J. Differential diagnosis of focal pancreatitis and pancreatic cancer.  Ann Oncol. 1999;  10 (Suppl 4) 85-88
    PubMedSearch in Google Scholar
  • 27 Warburg O. On the origin of cancer cells. Science 1956; 123 - 309
  • 28 Zimny M, Bares R, Fass J, Adam G, Cremerius U, Dohmen B, Klever P, Sabri O, Schumpelick V, Büll U. Fluorine-18 fluorodeoxyglucose positron emission tomography in the differential diagnosis of pancreatic carcinoma: a report of 106 cases.  Eur J Nucl Med. 1997;  24 (6) 678-682
    PubMedSearch in Google Scholar

Dr. med. Matthias Voth

Universitätsklinikum der Friedrich-Schiller-Universität Jena · Klinik für Radiologie · Abteilung für Nuklearmedizin

Bachstraße 18

07743 Jena

Phone: 0 36 41/93 39 34

Fax: 0 36 41/93 32 44

Email: Matthias.Voth@med.uni-jena.de