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18F-FDG PET/CT feature of pancreatic adenosquamous carcinoma with pathological correlation

  • Pancreas
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To investigate 18F-FDG PET/CT feature of pancreatic adenosquamous carcinoma (PASC) in contrast with conventional pancreatic ductal adenocarcinoma (PDAC), and its correlation with pathological findings.

Patients and methods

Patients with PASC or PDAC confirmed by surgical pathology, who underwent FDG PET/CT scanning before surgical resection, were retrospectively studied. PASC group and conventional PDAC group included 13 and 104 patients, respectively. Delayed phase of PET/CT scanning was performed in 12 patients with PASC and 99 with PDAC. Maximum standardized value (SUVmax) was measured, and the mean retention index (RI) was calculated by ([PET120min SUVmax]–[PET 60min SUVmax]) ÷ PET 60min SUVmax × 100%.

Results

On PET/CT, all lesions of PASC group showed intense FDG uptake, and the SUVmax were significantly higher than the lesions of conventional PDAC group both on the early [10.43 ± 5.10 (4.37–24.00) vs. 7.31 ± 3.86 (1.93–21.08), P = 0.011] and delayed phase [13.29 ± 6.04 (5.72–28.16) vs. 8.84 ± 5.14 (1.92–27.58), P = 0.005]. On the delayed phase, all lesions of PASC group had increased SUVmax with positive RI value (27.04% ± 8.87%, 7.14–39.27%). For conventional PDAC group, 81 lesions had increased SUVmax with positive RI value (27.25% ± 19.10%, 1.09–104.49%), while eighteen (18.18%) lesions of PDAC group had slightly decreased SUVmax, and their RI value were negative (− 11.35% ± 13.50%, − 43.17 to − 0.14%). The proliferative index (Ki-67) of lesions of PASC group was positively correlated with both the early (P = 0.034, r = 0.671) and delayed SUVmax (P = 0.019, r = 0.721). The RI value of lesions with adjacent organ invasion in PASC group was significantly higher than those without invasion (33.25% ± 4.92% vs. 20.83% ± 7.49%, P = 0.007).

Conclusion

PASC has more intense FDG uptake than conventional PDAC both on early and delayed phase. RI value of PASC was positive. Negative RI value may be helpful for differentiating PDAC from PASC. SUVmax and RI value may be helpful for prediction of its malignancy and invasion.

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Acknowledgements

This study is not supported by any institution.

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Author notes

  1. Weiwei Su and Shuai Zhao contributed equally to this article.

Authors and Affiliations

  1. Department of Nuclear Medicine, Changhai Hospital, Affiliated to the Second Military Medical University, Changhai Road 168, Yangpu District, Shanghai, 200433, People’s Republic of China

    Weiwei Su, Shuai Zhao, Changjing Zuo, Bin Cui & Fangyuan Ren

  2. Department of Pathology, Changhai Hospital, Affiliated to the Second Military Medical University, Changhai Road 168, Yangpu District, Shanghai, 200433, People’s Republic of China

    Ying Chen

  3. Department of Radiology, Changhai Hospital, Affiliated to the Second Military Medical University, Changhai Road 168, Yangpu District, Shanghai, 200433, People’s Republic of China

    Minjie Wang

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  1. Weiwei Su
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Correspondence to Fangyuan Ren.

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Su, W., Zhao, S., Chen, Y. et al. 18F-FDG PET/CT feature of pancreatic adenosquamous carcinoma with pathological correlation. Abdom Radiol 45, 743–749 (2020). https://doi.org/10.1007/s00261-019-02393-6

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