Diagnostic value of 18F-fluorodeoxyglucose positron emission tomography for pancreatic neuroendocrine tumors with reference to the World Health Organization classification

Masui,Toshihiko; Doi,Ryuichiro; Ito,Tatsuo; Kami,Kazuhiro; Ogawa,Kohei; Harada,Daisuke; Uemoto,Shinji

doi:10.3892/ol_00000029

Diagnostic value of 18F-fluorodeoxyglucose positron emission tomography for pancreatic neuroendocrine tumors with reference to the World Health Organization classification

Authors:
- Toshihiko Masui
- Ryuichiro Doi
- Tatsuo Ito
- Kazuhiro Kami
- Kohei Ogawa
- Daisuke Harada
- Shinji Uemoto
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Affiliations: Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, 606-8507 Kyoto, Japan
Published online on: January 1, 2010 https://doi.org/10.3892/ol_00000029
Pages: 155-159

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Abstract

The 2004 classification of the World Health Organization (WHO) has demonstrated an efficacy for prediction of the prognosis of pancreatic neuroendocrine tumors. This study aimed to assess the predictive value of preoperative 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in relation to the 2004 WHO criteria. The histology of 21 pancreatic endocrine tumors resected at our hospital was reviewed and the tumors were classified according to the 2004 WHO criteria. FDG-PET findings were analyzed by comparing the findings with CT scans. FDG uptake was positive in 10 primary endocrine tumors (47%), but no uptake was seen in 11 tumors. In relation to the 2004 WHO classification, 1 out of 8 well-differentiated tumors with benign behavior was positive by PET (12.5%), 4 out of 7 well-differentiated tumors with uncertain behavior were positive (57%) and 4 low-grade malignant tumors were positive (100%). According to the WHO criteria, the rate of positive FDG uptake increased as the malignant potential increased. The metastases of low-grade malignant tumors also showed a positive FDG uptake. In conclusion, from our limited experience, FDG-PET appears to be useful for identifying pancreatic neuroendocrine tumors with a higher malignant potential. In addition, FDG-PET can detect distant metastases and may contribute to better staging of advanced disease.

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1	Rha SE, Jung SE, Lee KH, Ku YM, Byun JY and Lee JM: CT and MR imaging findings of endocrine tumor of the pancreas according to WHO classification. Eur J Radiol. 62:371–377. 2007. View Article : Google Scholar : PubMed/NCBI
2	Modlin IM and Sandor A: An analysis of 8305 cases of carcinoid tumors. Cancer. 79:813–829. 1997. View Article : Google Scholar : PubMed/NCBI
3	Phan GQ, Yeo CJ, Hruban RH, Lillemoe KD, Pitt HA and Cameron JL: Surgical experience with pancreatic and peripancreatic neuroendocrine tumors: review of 125 patients. J Gastrointest Surg. 2:472–482. 1998.
4	Hochwald SN, Zee S, Conlon KC, Colleoni R, Louie O, Brennan MF and Klimstra DS: Prognostic factors in pancreatic endocrine neoplasms: an analysis of 136 cases with a proposal for low-grade and intermediate-grade groups. J Clin Oncol. 20:2633–2642. 2002. View Article : Google Scholar : PubMed/NCBI
5	Heitz PU, Komminoth P, Perren A, Klimstra DS, Dayal Y, Bordi C, Lechagon J, Centeno BA and Kloppel G: Tumours of the endocrine pancreas. Pathology and Genetics of Tumours of Endocrine Organs (World Health Organization Classification of Tumours). DeLellis RA, Lloyd RV, Heitz PU and Eng C: IARC Press; Lyon: pp. 177–182. 2004
6	Capella C, Heitz PU, Hofler H, Solcia E and Kloppel G: Revised classification of neuroendocrine tumors of the lung, pancreas and gut. Digestion. 55:11–23. 1994. View Article : Google Scholar : PubMed/NCBI
7	Bettini R, Boninsegna L, Mantovani W, Capelli P, Bassi C, Pederzoli P, Delle Fave GF, Panzuto F, Scarpa A and Falconi M: Prognostic factors at diagnosis and value of WHO classification in a mono-institutional series of 180 non-functioning pancreatic endocrine tumours. Ann Oncol. 19:903–908. 2008. View Article : Google Scholar : PubMed/NCBI
8	Schmitt AM, Anlauf M, Rousson V, Schmid S, Kofler A, Riniker F, Bauersfeld J, Barghorn A, Probst-Hensch NM, Moch H, Heitz PU, Kloeppel G, Komminoth P and Perren A: WHO 2004 criteria and CK19 are reliable prognostic markers in pancreatic endocrine tumors. Am J Surg Pathol. 31:1677–1682. 2007. View Article : Google Scholar : PubMed/NCBI
9	Ferrone CR, Tang LH, Tomlinson J, Gonen M, Hochwald SN, Brennan MF, Klimstra DS and Allen PJ: Determining prognosis in patients with pancreatic endocrine neoplasms: can the WHO classification system be simplified? J Clin Oncol. 25:5609–5615. 2007. View Article : Google Scholar : PubMed/NCBI
10	Reske SN and 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. 28:1707–1723. 2001.
11	Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, Maffioli L, Moncayo R, Mortelmans L and Reske SN: FDG-PET: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 30:BP115–124. 2003.PubMed/NCBI
12	Adams S, Baum R, Rink T, Schumm-Drager PM, Usadel KH and Hor G: Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours. Eur J Nucl Med. 25:79–83. 1998. View Article : Google Scholar : PubMed/NCBI
13	Pasquali C, Rubello D, Sperti C, Gasparoni P, Liessi G, Chierichetti F, Ferlin G and Pedrazzoli S: Neuroendocrine tumor imaging: can 18F-fluorodeoxyglucose positron emission tomography detect tumors with poor prognosis and aggressive behavior? World J Surg. 22:588–592. 1998. View Article : Google Scholar
14	Eriksson B, Bergstrom M, Orlefors H, Sundin A, Oberg K and Langstrom B: Use of PET in neuroendocrine tumors. In vivo applications and in vitro studies. Q J Nucl Med. 44:68–76. 2000.PubMed/NCBI
15	Eriksson B, Bergstrom M, Sundin A, Juhlin C, Orlefors H, Oberg K and Langstrom B: The role of PET in localization of neuroendocrine and adrenocortical tumors. Ann NY Acad Sci. 970:159–169. 2002. View Article : Google Scholar : PubMed/NCBI
16	Pawlikowski M and Melen-Mucha G: Somatostatin analogs from new molecules to new applications. Curr Opin Pharmacol. 4:608–613. 2004. View Article : Google Scholar : PubMed/NCBI
17	Pacak K, Eisenhofer G and Goldstein DS: Functional imaging of endocrine tumors: role of positron emission tomography. Endocr Rev. 25:568–580. 2004. View Article : Google Scholar : PubMed/NCBI
18	Sperti C, Pasquali C, Chierichetti F, Ferronato A, Decet G and Pedrazzoli S: 18-Fluorodeoxyglucose positron emission tomography in predicting survival of patients with pancreatic carcinoma. J Gastrointest Surg. 7:953–959. 2003. View Article : Google Scholar : PubMed/NCBI
19	Vansteenkiste JF, Stroobants SG, Dupont PJ, De Leyn PR, Verbeken EK, Deneffe GJ, Mortelmans LA and Demedts MG: Prognostic importance of the standardized uptake value on (18)F-fluoro-2-deoxy-glucose-positron emission tomography scan in non-small-cell lung cancer: An analysis of 125 cases. Leuven Lung Cancer Group. J Clin Oncol. 17:3201–3206. 1999.
20	Downey RJ, Akhurst T, Gonen M, Vincent A, Bains MS, Larson S and Rusch V: Preoperative F-18 fluorodeoxyglucose-positron emission tomography maximal standardized uptake value predicts survival after lung cancer resection. J Clin Oncol. 22:3255–3260. 2004. View Article : Google Scholar