Positron-emission tomography and computed tomography of cystic pancreatic masses

M. Tann, Kumar Sandrasegaran, S. G. Jennings, A. Skandarajah, Lee McHenry, C. Schmidt

Research output: Contribution to journalArticle

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Abstract

Aim: To investigate the sensitivity and specificity of computed tomography (CT), positron-emission tomography (PET), and both methods in combination, for determining whether cystic pancreatic tumours are malignant. Materials and methods: We retrospectively identified all patients with cystic pancreatic tumours who underwent separate PET and contrast-enhanced CT examinations within a 1-month interval. Tumours were classified as benign or malignant on CT (two radiologists, independently), PET [a reported standardized uptake value (SUV) of 2.5 was taken as the cut-off between benign and malignant], and with PET and CT images together (two radiologists, in consensus). Readers were blinded to pathological and other radiological findings. Mean patient age and lesion size were compared between benign and malignant groups using Student's t-test. For CT findings, odds ratios (OR) and confidence intervals (CI) were calculated using multivariate logistic regression models. For CT, PET, and the combined images, sensitivities and specificities were calculated, and compared between groups using Fisher's exact test. Results: Thirty patients were identified. The best CT predictor of malignancy was size; mean diameter was 2.3 cm (benign) and 4.1 cm (malignant) (p < 0.01); OR was 2.80 (95% CI, 1.26-6.20). Sensitivities of CT, PET and combined PET/CT images were 67-71, 57, and 86%, respectively. PET/CT was more sensitive than PET (p < 0.01) or CT (p < 0.01) alone. Specificities of CT, PET, and combined PET/CT images were 87-90, 65, and 91%, respectively. PET/CT was more specific than PET (p < 0.01) but not CT (p > 0.05). Conclusion: The sensitivity and specificity of combined PET and CT images is comparable with or superior to either CT or PET alone in determining malignancy in cystic pancreatic lesions.

Original languageEnglish
Pages (from-to)745-751
Number of pages7
JournalClinical Radiology
Volume62
Issue number8
DOIs
StatePublished - Aug 2007

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Tomography
Positron-Emission Tomography
Neoplasms
Sensitivity and Specificity
Logistic Models
Odds Ratio
Positron Emission Tomography Computed Tomography
Confidence Intervals
Students
Radiologists

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Positron-emission tomography and computed tomography of cystic pancreatic masses. / Tann, M.; Sandrasegaran, Kumar; Jennings, S. G.; Skandarajah, A.; McHenry, Lee; Schmidt, C.

In: Clinical Radiology, Vol. 62, No. 8, 08.2007, p. 745-751.

Research output: Contribution to journalArticle

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abstract = "Aim: To investigate the sensitivity and specificity of computed tomography (CT), positron-emission tomography (PET), and both methods in combination, for determining whether cystic pancreatic tumours are malignant. Materials and methods: We retrospectively identified all patients with cystic pancreatic tumours who underwent separate PET and contrast-enhanced CT examinations within a 1-month interval. Tumours were classified as benign or malignant on CT (two radiologists, independently), PET [a reported standardized uptake value (SUV) of 2.5 was taken as the cut-off between benign and malignant], and with PET and CT images together (two radiologists, in consensus). Readers were blinded to pathological and other radiological findings. Mean patient age and lesion size were compared between benign and malignant groups using Student's t-test. For CT findings, odds ratios (OR) and confidence intervals (CI) were calculated using multivariate logistic regression models. For CT, PET, and the combined images, sensitivities and specificities were calculated, and compared between groups using Fisher's exact test. Results: Thirty patients were identified. The best CT predictor of malignancy was size; mean diameter was 2.3 cm (benign) and 4.1 cm (malignant) (p < 0.01); OR was 2.80 (95{\%} CI, 1.26-6.20). Sensitivities of CT, PET and combined PET/CT images were 67-71, 57, and 86{\%}, respectively. PET/CT was more sensitive than PET (p < 0.01) or CT (p < 0.01) alone. Specificities of CT, PET, and combined PET/CT images were 87-90, 65, and 91{\%}, respectively. PET/CT was more specific than PET (p < 0.01) but not CT (p > 0.05). Conclusion: The sensitivity and specificity of combined PET and CT images is comparable with or superior to either CT or PET alone in determining malignancy in cystic pancreatic lesions.",
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