PET/CT With Radiotracer Can Help Diagnose Acute Pancreatitis

August 6, 2014

Using PET/CT with 18F-fluorodeoxyglucose–labeled leukocytes is a noninvasive and reliable method to help diagnose acute pancreatitis.

PET plus CT with 18F-fluorodeoxyglucose (FDG)–labeled leukocytes can be used to diagnose infection in pancreatic or peripancreatic fluid collections in patients with acute pancreatitis (AP), according to a study published in The Journal of Nuclear Medicine.

Researchers from India undertook a study to determine if using PET/CT with 18F-FDG–labeled leukocytes for early detection of AP could affect the choice of treatment and clinical outcomes of patients who had acute pancreatitis.

The study included 28 men and 13 women, mean age 41. All were diagnosed with AP and had radiologic evidence of fluid collection in or around the pancreas. The radiotracer 18F-FDG was added to leukocytes that had been separated from the patients’ venous blood, and then was intravenously administered back to the patient. The patients then underwent PET/CT imaging two hours after receiving the radiotracer. Final diagnosis of AP was based on microbiologic culture of fluid aspirated from the collection.

Results:

TestsValues
Blood glucose level83 to 212 mg/100 mL (118 ± 30)
Total leukocyte count4,600 to 24,200/mm
Neutrophil count55 percent to 90 percent (73 ± 10)
Leukocyte labeling efficiency31 percent to 97 percent (81 ± 17)

There was an increased tracer uptake in the fluid collection in 12 of 41 patients. Ten patients had culture-proven infection and underwent percutaneous drainage. Aspiration was unsuccessful in two. “The scan results were negative for infection in 29 patients; 25 had fluid culture results that were negative for infection, and aspiration was unsuccessful in four,” the authors wrote. “The sensitivity, specificity, and accuracy of the scan were all 100 percent in 35 patients for whom fluid culture reports were available.”

The authors concluded that PET/CT with 18F-FDG–labeled leukocytes is both a noninvasive and reliable method for the diagnosis of infection in pancreatic or peripancreatic fluid collections in patients with AP.