PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer

Overall survival for patients with pancreatic cancer remains poor. Challenges in the care of patients with pancreatic cancer include late presentation and difficulties in early diagnosis. Standard diagnosis of patients with pancreatic cancer consists of a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan and camera tests. Additional imaging tests may be able to identify pancreatic cancer and the stage of disease more effectively. This would mean that patients would receive the most appropriate treatment at the right time. Positron emission tomography (PET)/CT is a nuclear medicine scan that gives a functional image of the body along with the CT scan. This study used PET/CT in patients with suspected pancreatic cancer as well as standard tests to see if the diagnosis and treatment of these patients could be improved. In total, 550 patients had PET/CT scans. The PET/CT added significantly to the accuracy of standard tests, improving the diagnosis of pancreatic cancer. PET/CT influenced the management of 45% of patients. PET/CT was able to correctly stage the extent of the tumours in a greater number of patients than standard diagnostic tests. This meant that the addition of PET/CT changed the management of these patients to more appropriate therapies. The biggest benefit was seen for those patients who were due to have surgery. We calculated that the use of PET/CT was likely to be good value for money for the NHS. This study suggests that PET/CT is likely to be beneficial in the diagnosis and management of patients with suspected pancreatic cancer.