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Clinical correlations with (18)FDG PET scan patterns in solid pseudopapillary tumors of the pancreas: still a surgical enigma?

Authors
 Chang Moo Kang  ;  Arthur Cho  ;  Hyunki Kim  ;  Young Eun Chung  ;  Ho Kyoung Hwang  ;  Sung Hoon Choi  ;  Woo Jung Lee 
Citation
 PANCREATOLOGY, Vol.14(6) : 515-523, 2014 
Journal Title
PANCREATOLOGY
ISSN
 1424-3903 
Issue Date
2014
MeSH
Adult ; Aged ; Carcinoma, Papillary/diagnostic imaging* ; Carcinoma, Papillary/surgery* ; Female ; Fluorodeoxyglucose F18 ; Glucose Transporter Type 1/metabolism ; Hexokinase/metabolism ; Humans ; Male ; Middle Aged ; Pancreas/enzymology ; Pancreas/pathology ; Pancreatectomy ; Pancreatic Neoplasms/diagnostic imaging* ; Pancreatic Neoplasms/surgery* ; Positron-Emission Tomography ; Radiopharmaceuticals ; Retrospective Studies
Keywords
2-Deoxy-2-[(18)F] fluoro-d-glucose ((18)F-FDG) ; GLUT-1 ; Pancreatectomy ; Positron emission tomography (PET) ; Solid pseudopapillary tumor ; Tumor Metabolism
Abstract
BACKGROUND: There are limited numbers of PET studies of solid pseudopapillary tumors (SPT) of the pancreas.
MATERIALS AND METHODS: We reviewed the medical records of 37 patients who underwent resection of pancreatic SPT and had been preoperatively evaluated by (18)F-FDG PET or PET/CT scan. Immunohistochemical analysis of glucose transporter-1 (GLUT-1) and hexokinase II (HK-II) was performed.
RESULTS: SPT could be categorized into five types according to the morphologic characteristics observed in PET images. Type I (hot FDG uptake in the entire tumor portion) was the most frequent (13, 34.2%), followed by type IV (focal uptake, 12, 31.6%), II (focal defect, 8, 21.1%), III (multiple and geographic uptake, 3, 7.9%), and V (total defective type, 1, 2.6%). The SUVmax in the solid portion of the SPT was 5.3 ± 4.1. The clinical pattern of FDG uptake in SPT was not associated with histopathologic features suggesting malignant potential. The SUVmax of SPT followed a pattern according to pattern of FDG uptake (R(2) = 0.203, p = 0.055), and was significantly associated with adjusted tumor volume (p = 0.001). GLUT-1 was not expressed in SPT, and only eight patients (12.3%) showed mild to moderate expression of HK-II, which was associated with the clinical pattern of SPT in PET images (p < 0.05).
CONCLUSION: SPT of the pancreas could be categorized according to the morphologic patterns observed in PET images. The clinical significance of FDG uptake, glucose metabolism, and clinical usefulness of PET scan in SPT need to be further investigated, and thus this tumor remains a surgical enigma.
Full Text
http://www.sciencedirect.com/science/article/pii/S142439031400965X
DOI
10.1016/j.pan.2014.08.003.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
Choi, Sung Hoon(최성훈)
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138369
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