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Prospective evaluation of the clinical utility of 18-fluorodeoxyglucose PET CT scanning in patients with von hippel-lindau-associated pancreatic lesions.
[von hippel-lindau disease]
The
natural
history
of
pancreatic
neuroendocrine
neoplasms
(
PNENs
)
in
patients
with
Von
Hippel-
Lindau
(
VHL
)
disease
is
poorly
defined
.
Management
of
patients
with
PNENs
is
challenging
because
there
are
no
reliable
preoperative
criteria
to
detect
malignant
lesions
,
and
the
majority
of
resected
tumors
are
found
to
be
benign
.
The
aim
of
this
study
was
to
determine
whether
18
-
fluorodeoxyglucose-positron
emission
tomography
(
(
18
)
FDG-PET
)
uptake
predicts
growth
and
detects
malignant
VHL
-associated
PNENs
.
We
performed
a
prospective
study
of
197
patients
with
VHL
-associated
pancreatic
lesions
.
Clinical
and
imaging
characteristics
were
analyzed
to
study
the
associations
between
FDG-PET
uptake
,
tumor
growth
,
and
the
development
of
metastatic
disease
.
One
hundred
nine
of
197
patients
had
solid
pancreatic
lesions
and
underwent
both
CT
and
(
18
)
FDG-PET
scanning
,
which
identified
165
and
144
lesions
,
respectively
.
Metastatic
disease
was
detected
by
(
18
)
FDG-PET
in
3
patients
in
whom
it
was
not
detected
by
CT
scan
and
suggested
non-neoplastic
disease
in
3
patients
.
Maximum
standardized
uptake
values
(
SUV
)
on
(
18
)
FDG-PET
correlated
with
tumor
size
on
CT
(
r
=
0
.
47
,
p
<
0
.
0001
)
,
and
an
increase
in
SUVmax
was
associated
with
tumor
growth
(
r
=
0
.
36
,
p
=
0
.
0062
)
.
No
association
was
seen
between
(
18
)
FDG-PET
uptake
and
age
,
VHL
genotype
,
or
serum
chromogranin
A
levels
.
Scanning
with
FDG-PET
identifies
metastatic
disease
not
detected
by
CT
scan
and
avoids
resection
of
non-
PNEN
lesions
that
have
no
malignant
potential
in
patients
with
VHL
-associated
PNENs
.
It
should
be
considered
as
a
valuable
functional
imaging
modality
in
the
clinical
management
of
patients
with
VHL
-associated
PNENs
.
Diseases
Validation
Diseases presenting
"solid pancreatic lesions"
symptom
von hippel-lindau disease
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