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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
"tumor growth"
symptom
adrenal incidentaloma
carcinoma of the gallbladder
cholangiocarcinoma
cowden syndrome
cystinuria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
hodgkin lymphoma, classical
liposarcoma
lymphangioleiomyomatosis
primary effusion lymphoma
severe combined immunodeficiency
von hippel-lindau disease
waldenström macroglobulinemia
wiskott-aldrich syndrome
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