Figure 27.

Highly variable appearance of highly mucinous pancreatic neoplasms on FDG PET-CT: (a–e). (a,b) Mucinous adenocarcinoma of the body of the pancreas is low attenuation on axial contrast-enhanced CT (a) and yet highly metabolically active on axial fused FDG PET-CT (b) (white arrowheads); (c) Complex cystic mass in the head of the pancreas is a highly mucinous cystadenocarcinoma and shows no metabolic activity on axial fused FDG PET-CT (white arrowhead). The differential diagnosis would include pseudocyst from prior pancreatitis; (d) A mucinous adenocarcinoma of the tail of the pancreas shows only mild uptake on axial fused FDG PET-CT (white arrowhead); (e) The same pancreatic mass as (d) has metastasized to the right iliac bone and sacrum (white arrowhead). Although the pancreatic mass shows only mild metabolic activity, the pelvic metastasis from this same tumor is strongly hypermetabolic.