Korean J Gastroenterol.  2012 May;59(5):347-353. 10.4166/kjg.2012.59.5.347.

Usefulness of 18F-fluoro-2-deoxyglucose Positron Emission Tomography in Evaluation of Gastric Cancer Stage

• Yoon NR
• Park JM
• Jung HS
• Cho YK
• Lee IS
• Choi MG
• Chung IS
• Song KY
• Park CH

• KMID: 1792833
• DOI: http://doi.org/10.4166/kjg.2012.59.5.347

Abstract

BACKGROUND/AIMS
The usefulness of 18F-fluoro-2-deoxyglucose (FDG)-PET in detecting primary cancer, lymph node metastasis, and distant metastasis were studied in the gastric cancer patients.
METHODS
The subjects were 392 gastric cancer patients who received FDG-PET and an abdominal CT test prior to surgery. The results of FDG-PET and CT were compared with the surgical and pathologic results.
RESULTS
The primary site detection rate of FDG-PET was 74.4%, 50.3% in early gastric cancer and 92.0% in advanced gastric cancer. Detection rate was higher when tumors were larger than 3.5 cm, had deeper depth of invasion, and at a later stage (p<0.05, respectively). In multivariate analysis, tumor size, spread of tumor cells beyond the muscle layer (> or =T2), and lymph node metastasis were statistically significant factors in primary site detection rate. The sensitivity, specificity, and positive predictive value of FDG-PET to lymph node metastasis were 59.6%, 88.8%, and 81.1% respectively, sensitivity being lower compared to CT while specificity and positive predictive value were higher. Sensitivity, specificity, and positive predictive value to distant metastasis were, respectively, 66.7%, 99.2%, and 88.0%, similar to CT. In 21 of the 392 patients (5.4%), synchronous double primary cancers were detected.
CONCLUSIONS
In gastric cancer, usefullness of FDG-PET is limited to the advanced stage. Diagnostic value of this test was not superior to CT. However, FDG-PET may be useful in detecting synchronous double primary cancers.

Keyword

Stomach neoplasms; Fluorodeoxyglucose F18; Positron-emission tomography; Lymph nodes; Neoplasm metastasis

MeSH Terms

Aged
Female
Fluorodeoxyglucose F18/chemistry/*diagnostic use
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Positron-Emission Tomography
Predictive Value of Tests
ROC Curve
Radiopharmaceuticals/chemistry/*diagnostic use
Retrospective Studies
Stomach Neoplasms/*diagnosis/radionuclide imaging
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Detection rate of gastric cancer with 18F-fluoro-2-deoxyglucose (FDG)-PET according to tumor size. ROC, receiver operating characteristic.

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