Pancreatic PET stress test could eliminate cumbersome testing

A minimally invasive PET scan could tell clinicians about a patient’s exocrine function without all of the usual pains of conventional testing, according to a study published May 19 in the Journal of Nuclear Medicine.

Chronic pancreatitis is a common ailment. In developed countries, the prevalence is thought to be around 30 cases in 100,000 but autopsy reports bump that number up to 5 percent of the population. However the standard of care for evaluating the exocrine function of the pancreas involves invasive placement tubes and fluid capture over a duration of time. Anything less invasive has been found to be less sensitive and therefore less effective.

Joo Hyun O, MD, a researcher from the division of nuclear medicine, Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins University School of Medicine in Baltimore, and colleagues evaluated C-11 acetate PET as a means of identifying pancreatic exocrine dysfunction.

“The transition from acute pancreatitis, which is the second most common gastrointestinal discharge diagnosis in the United States, to chronic pancreatitis is challenging to identify,” wrote the authors. “The purpose of this pilot study was to develop a noninvasive and sensitive pancreas function test. Such a test could aid in the diagnosis of early pancreatic dysfunction resulting from chronic pancreatitis.”

For this study, five healthy subjects with no known pancreatic disease underwent C-11 acetate PET/CT before and after being administered secretin, a hormone that regulates secretions of the pancreas and stomach. Results showed clear uptake in the duodenum and changes in the pancreas based on kinetic analysis as a result of perfusion. Limiting factors were the short half-life of the tracer and the small study size.   

“Dynamic C-11 acetate PET studies before and after secretin stimulation are a promising and innovative, noninvasive approach for assessing basal and stimulated pancreatic exocrine function," the researchers wrote. "Future studies should include both additional control subjects and additional patients with pancreatic diseases.”