PET-CT in the staging of potentially resectable pancreatic cancer

Background Pancreatic adenocarcinoma (PDAC) presents a significant global health challenge particularly as it is generally diagnosed at an advanced stage. Although cross-sectional imaging techniques including multidetector CT (MDCT) are familiar and ubiquitously used the role and value of PET-CT scans in PDAC management remains unclear. Methods This six-year study analysed patients who underwent PET-CT scans for suspected PDAC. Demographics, cross-sectional imaging and PET-CT results, management decisions, and histology were collected together with rates of operation with curative intent and the time interval between scans and surgical intervention. Results Of 161 patients, 110 were operable, but 51 weren't. Among operable ones, 20 had extra-pancreatic lesions; 90 didn't. Without extra-pancreatic lesions, 68 underwent surgery, 12 unfit, and 10 had benign conditions. Among those explored, 9 had unconfirmed suspected metastasis. Of all explored, 48 had successful resection; 20 had precluding diseases. In the subset with extra-pancreatic lesions, 4 were inoperable due to confirmed metastasis. The remaining 16 explored had equivocal or unrelated lesions; 9 were resectable, 7 weren't. PET-CT scans impacted patient management in 8% of cases. Conclusions PET-CT scans play a crucial role in the management of suspected PDAC, but routine use may not be justified. Further research is needed to identify the subset of patients who benefit most. Clear guidelines for PET scan utilization in clinical practice are required to optimize the role in PDAC management.