The Value Of ¹⁸F-FDG PET/CT In The Diagnosis Of Periampullary Lesions And Its Influence On The Treatment Decision

Purpose:To investigate the value of ¹⁸F-FDG PET-CT in the diagnosis and differential diagnosis of periampullary lesions and its influence on treatment decisions.Methods:This study retrospectively analyzed the clinical data of 55 patients who were initially diagnosed as periampullary lesions and further underwent ¹⁸F-FDG PET-CT examination in shandong cancer hospital from January 1,2015 to December 31,2018.The purpose of this comparison was to further analyze the value of ¹⁸F-FDG PET-CT in the diagnosis and differential diagnosis of periampullary lesions,and whether the increase in PET-CT examination would change patients'treatment decisions and thereby benefit patients.The surgical method,postoperative pathological diagnosis and final diagnosis were the gold standard.To compare the efficacy of enhanced CT and CT combined ¹⁸F-FDG PET-CT in the diagnosis and surgical indication evaluation of periampullary lesions.At the same time,the impact of adding ¹⁸F-FDG PET-CT examination on the treatment decision and its clinical value were evaluated.SPSS19.0 was used for statistical analysis,and the counting data were compared by chi-square test or Fisher's exact probability test,p<0.05 was considered statistically significant.Results:Among the 55 patients initially diagnosed as periampullary lesions by CT,11were confirmed as benign lesions and 44 were confirmed as malignant lesions by surgery or follow-up visit.The sensitivity,specificity and accuracy of CT combined with ¹⁸F-FDG PET-CT for evaluating benign and malignant lesions of periampullary lesions were 100%?44/44?,90.9%?10/11?and 98.2%?54/55?,compared to 95.5%?42/44?,27.3%?3/11?and 81.8%?45/55?of CT,the differences of specificity and accuracy were statistically significant?x²=6.77,p=0.009;x²=8.18,p=0.004?.The sensitivity,specificity and accuracy of CT combined with ¹⁸F-FDG PET-CT for evaluating distant metastasis of malignant lesion around ampulla region were 100%?12/12?,100%?32/32?and 100%?44/44?,compared to58.3%?7/12?,93.8%?30/32?and 84.1%?37/44?of CT,the differences of sensitivity and accuracy were statistically significant?x²=4.04,p=0.044;x²=5.59,p=0.018?;The sensitivity,specificity and accuracy of CT combined with ¹⁸F-FDG PET-CT for evaluating surgical indications respectively were 100%?21/21?,87.0%?20/23?and 93.2%?41/44?,compared to95.2%?20/21?,60.9%?14/23?and 77.3%?34/44?of CT,the differences of specificity and accuracy were statistically significant?x²=4.06,p=0.044;x²=4.42,p=0.035?.Conclusion:Studies have shown that ¹⁸F-FDG PET-CT is of great value in the diagnosis and differential diagnosis of periampullary lesions.CT combined with PET-CT improved the accuracy of evaluating distant metastasis and surgical indication of periampullary malignant lesions.The addition of PET-CT can change their treatment decisions...