Yonsei Med J.  2011 Jan;52(1):81-88. 10.3349/ymj.2011.52.1.81.

The Role of 18F-FDG PET/CT in the Evaluation of Gastric Cancer Recurrence after Curative Gastrectomy

• Lee JE
• Hong SP
• Ahn DH
• Jeon TJ
• Kang MK
• Kwon CI
• Ko KH
• Hwang SG
• Park PW
• Rim KS

• KMID: 1106441
• DOI: http://doi.org/10.3349/ymj.2011.52.1.81

Abstract

PURPOSE
18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans are frequently performed for the screening or staging of malignant tumors. This study aimed to assess the usefulness of 18F-FDG PET/CT in detection of gastric cancer recurrence after curative gastrectomy.
MATERIALS AND METHODS
Eighty nine patients who had undergone curative gastrectomy due to gastric cancer and had 18F-FDG PET/CT and contrast CT scans within 2 weeks for surveillance in asymptomatic patients (n = 11) or to clarify suspected recurrence (n = 78) were consecutively collected and retrospectively analyzed. They had clinical follow-up for at least 12 months after PET/CT and CT scans.
RESULTS
Fifteen of the 89 patients (16.9%) were diagnosed with recurrent gastric cancer in 21 organs. Forty one organs showed an increase in FDG uptake, and only 9 of these organs were diagnosed with recurrent gastric cancer by 18F-FDG PET/CT. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the 18F-FDG PET/CT were 42.9%, 59.7%, 29.3%, 78.2%, and 57.3%, respectively. On the CT scan, 18 of 21 recurrent gastric cancers were detected, and 7 cases were in agreement with the 18F-FDG PET/CT. The sensitivity and specificity of the CT scan were 85.8% and 87.3%, respectively, which are superior to the 18F-FDG PET/CT. When we diagnosed a recurrence based on either 18F-FDG PET/CT or CT scans, the sensitivity increased to 95.2% and the specificity decreased to 45.6%, when compared with the contrast CT scan alone.
CONCLUSION
18F-FDG PET/CT is an insufficient diagnostic method in detection of recurrence after curative gastrectomy, and even less accurate than contrast CT scan alone.

Keyword

Gastric cancer; recurrence; 18F-FDG PET/CT scan; contrast CT scan

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Fluorodeoxyglucose F18/*diagnostic use
*Gastrectomy
Humans
Male
Middle Aged
Neoplasm Recurrence, Local/*diagnosis
Positron-Emission Tomography/*methods
Stomach Neoplasms/*diagnosis/*surgery
Tomography, X-Ray Computed/*methods