Investigation of Fluorodeoxyglucose Positron Emission Tomography for the Diagnosis of Solid Pseudopapillary Neoplasm of the Pancreas: A Study Associated With a National Survey of Solid Pseudopapillary Neoplasms

Pancreas. 2019 Nov/Dec;48(10):1312-1320. doi: 10.1097/MPA.0000000000001424.

Abstract

Objectives: This study aimed to investigate the utility of fluorodeoxyglucose (FDG) positron emission tomography for solid pseudopapillary neoplasm (SPN) diagnosis.

Methods: The subjects included 53 cases of SPN. We compared the maximal standardized uptake volume (SUVmax) with those of 25 cases of pancreatic duct cancer and 18 cases of pancreatic neuroendocrine neoplasm. In addition, immunopathological testing for SPN with regard to FDG uptake was undertaken.

Results: An increase in SUVmax was observed in all tumors with increased tumor diameter. Among tumors of 20 mm or smaller, the SUVmax of SPN was significantly higher than those of pancreatic duct cancer and pancreatic neuroendocrine neoplasm. The results of a pathological study of FDG uptake in SPN revealed increased glucose transporter protein type 1 expression with tumor enlargement. Furthermore, increased hypoxia-inducible factor-1 and vascular endothelial growth factor expression under hypoxic conditions were observed in the areas of necrosis.

Conclusions: In cases in which high FDG uptake is observed in small pancreatic tumors, FDG positron emission tomography is potentially useful for SPN differentiation. The factors involved in FDG uptake in SPN include cell density and glucose transporter protein expression, as well as hypoxia-inducible factor and vascular endothelia growth factor expression in the hypoxic environment of necrotic areas.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carcinoma, Papillary / chemistry
  • Carcinoma, Papillary / diagnostic imaging*
  • Carcinoma, Papillary / pathology
  • Child
  • Female
  • Fluorodeoxyglucose F18*
  • Glucose Transporter Type 1 / analysis
  • Humans
  • Hypoxia-Inducible Factor 1 / analysis
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / chemistry
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals*
  • Vascular Endothelial Growth Factor A / analysis
  • Young Adult

Substances

  • Glucose Transporter Type 1
  • Hypoxia-Inducible Factor 1
  • Radiopharmaceuticals
  • SLC2A1 protein, human
  • Vascular Endothelial Growth Factor A
  • Fluorodeoxyglucose F18