In 22 patients with focal pancreatic lesions, the values of different diagnostic modalities
were analysed for the evaluation of malignancy. The CA 19-9 level was elevated in
4/5 malignant cases (sensitivity: 80%) and in 4/15 of benign cases (specificity: 73%).
Hypodensity/hypoechogeneity was considered to be the characteristic sign of malignancy
during CT/ultrasound (sensitivity: 100%, specificity: 50%/47%). ERCP was found to
be specific but not sensitive enough and the rate of unsuccessful investigations was
relatively high (4/22). The diagnostic value of FDG-PET was found to be superior to
other diagnostic modalities (sensitivity 100%, specificity 88%). In cases with focal
pancreatic hypoechogenic/hypodense lesions detected by CT or US in suspicion of malignancy,
the FDG-PET should be the next step in the diagnostic strategy.