Evidence map›Paper›PMID 33001304›Full record

ArticleEuropean radiology2021

Differentiating benign and malignant pancreatic masses: Ga-68 PSMA PET/CT as a new diagnostic avenue.

Venkata Subramanian Krishnaraju, Rajender Kumar, Bhagwant Rai Mittal, Vishal Sharma, Harjeet Singh, Ritambhra Nada, Amanjit Bal, Manish Rohilla, Harmandeep Singh, Surinder S Rana

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Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
1.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 24 citations in OpenAlex.

  1. Cancer imaging : the official publication of the International Cancer Imaging Society · 2025
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  4. Current trends in the characterization and monitoring of vascular response to cancer therapy.Cancer imaging : the official publication of the International Cancer Imaging Society · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Venkata Subramanian KrishnarajuDepartment of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Rajender KumarDepartment of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Bhagwant Rai MittalDepartment of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India. brmittal@yahoo.com.ORCID http://orcid.org/0000-0002-0016-5783
Vishal SharmaDepartment of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Harjeet SinghDepartment of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Ritambhra NadaDepartment of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Amanjit BalDepartment of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Manish RohillaDepartment of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Harmandeep SinghDepartment of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Surinder S RanaDepartment of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Post Graduate Institute of Medical Education and Research · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDifferentiation of malignant and benign pancreatic lesions on anatomical imaging is difficult in some cases with overlapping features. Prostate-specific membrane antigen (PSMA) is overexpressed during angioneogenesis in many tumors. We aimed to evaluate the PSMA expression in pancreatic lesions to differentiate these lesions and explore the performance of Ga-68 PSMA-PET/CT vis-a-vis F-18 FDG-PET/CT.

methodsPatients with pancreatic lesions on conventional imaging were prospectively recruited. All the patients underwent a whole-body F-18 FDG-PET/CT and a regional abdominal Ga-68 PSMA-PET/CT. Focal tracer uptake (FDG or PSMA) on PET images was considered positive. Histopathology and/or cytopathology were considered the reference standard.

resultsA total of forty patients (27 males, mean age 55.3 ± 9.8, range 37-71 years) were enrolled. Of these, 19 were diagnosed as malignant on histopathology/cytology. Patients with benign lesions showed no worsening of symptoms for at least 6 months on follow-up. FDG-PET/CT revealed 17 true-positive (TP), 9 false-positive (FP), 12 true-negative (TN), and 2 false-negative (FN) findings, whereas PSMA-PET/CT had 18 TP, 2 FP, 19 TN, and 1 FN finding. The sensitivity, specificity, PPV, NPV, and accuracy for FDG-PET/CT were 89.5%, 57.1%, 65.4%, 85.7%, and 72.5%, respectively, while for PSMA-PET/CT were 94.7%, 90.5%, 90%, 95%, and 92.5%, respectively. ROC curve analysis showed that the SUVmax value of 4.8 on PSMA-PET/CT could predict the malignant potential of a lesion with a specificity of 90.5% and a sensitivity of 84.2%.

conclusionsGa-68 PSMA-PET/CT imaging helped in establishing a non-invasive pre-operative diagnosis of primary pancreatic malignancy with a higher degree of specificity and accuracy compared with FDG-PET/CT. KEY POINTS: • Conventional imaging such as CT and MRI are unable to reliably differentiate localized malignant pancreatic lesion from benign lesions mimicking malignancy such as mass-forming pancreatitis. • FDG PET/CT helps in detecting malignant foci in view of their increased glucose metabolism. However, it may be falsely positive in inflammatory lesions which may occasionally hinder its ability to differentiate between benign and malignant lesions. • Apart from prostatic malignancy, PSMA is overexpressed in neovasculature of many non-prostatic malignancies. The present study highlights that Ga68 PSMA PET/CT performed better in diagnosing malignancy non-invasively than FDG-PET/CT with a higher PPV (90.5% vs. 65.4%) and accuracy (92.5% vs. 72.5%).

Indexed as

Gallium RadioisotopesPositron Emission Tomography Computed TomographyAdultAgedFluorodeoxyglucose F18HumansMaleMiddle AgedPositron-Emission TomographyRadiopharmaceuticalsTomography, X-Ray ComputedFluorodeoxyglucose F18Gallium-68Gallium RadioisotopesRadiopharmaceuticalsFluorodeoxyglucose F18Ga-68 labeled PSMAGlutamate carboxypeptidase IIPancreatic neoplasmsPositron emission tomography computed tomography

Identifiers

PMID33001304
OpenAlexW3091415592

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.