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Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose
positron emission tomography (FDG PET)
mUsefulness and limitations in "clinical reality"—
-231 cases of pancreatic lesions
-It’s cheap and useful, can detect lesions as small as 7mm and by looking
at them in high resolution, Doctors can differentiate between pancreatitis
and pancreatic cancer. It is feasible to use it as a differential diagnosis
tool, however more research needs to be done.
-However, when looking at sensitivity and specificity on page 7, EUS
seems to be the better bet
-Not to mention, each time one gets a PET scan, they are exposed to
radiation.
-“As for false-positive cases, active and chronic pancreatitis and
autoimmune pancreatitis sometimes show high FDG accumulation and
mimic pancreatic cancer with a shape of focal uptake.”
-Document from 2003, things have changed in 7 years.
-FDG in this study stands for fluorine-18 fluorodeoxyglucose
-fluorine-18 fluorodeoxyglucose goes into the cytosol of a cell and if
overexpression of GLUTs (glucose transporter proteins) is present,
pancreatic cancer can be detected.
-The FDG gets trapped in malignant tumor cells when it is
phosphorylated (goes through the process of glycolysis—which is part of
the energy production cycle of a cell).
-Average Sensitivity- 90%
-Average Specificity- 81%
-No Medicare reimbursement for PET scans for pancreatic cancer, why
make the old people pay so much for a scan that Medicare won’t help
with?
-After reading the entire article, PET should not be used for diagnostics,
but maybe for monitoring once pancreatitis or pancreatic cancer has been
identified.