J Korean Surg Soc.  2011 Aug;81(2):104-110. 10.4174/jkss.2011.81.2.104.

F18-fluorodeoxyglucose-positron emission tomography and computed tomography is not accurate in preoperative staging of gastric cancer

• Ha TK
• Choi YY
• Song SY
• Kwon SJ

• KMID: 2096663
• DOI: http://doi.org/10.4174/jkss.2011.81.2.104

Abstract

PURPOSE
To investigate the clinical benefits of F18-fluorodeoxyglucose-positron emission tomography and computed tomography (18F-FDG-PET/CT) over multi-detector row CT (MDCT) in preoperative staging of gastric cancer.
METHODS
FDG-PET/CT and MDCT were performed on 78 patients with gastric cancer pathologically diagnosed by endoscopy. The accuracy of radiologic staging retrospectively was compared to pathologic result after curative resection.
RESULTS
Primary tumors were detected in 51 (65.4%) patients with 18F-FDG-PET/CT, and 47 (60.3%) patients with MDCT. Regarding detection of lymph node metastasis, the sensitivity of FDG-PET/CT was 51.5% with an accuracy of 71.8%, whereas those of MDCT were 69.7% and 69.2%, respectively. The sensitivity of 18F-FDG-PET/CT for a primary tumor with signet ring cell carcinoma was lower than that of 18F-FDG-PET/CT for a primary tumor with non-signet ring cell carcinoma (35.3% vs. 73.8%, P < 0.01).
CONCLUSION
Due to its low sensitivity, 18F-FDG-PET/CT alone shows no definite clinical benefit for prediction of lymph node metastasis in preoperative staging of gastric cancer.

Keyword

Gastric cancer; 18F-FDG-PET/CT; MDCT; Preoperative staging

MeSH Terms

Carcinoma, Signet Ring Cell
Endoscopy
Humans
Lymph Nodes
Neoplasm Metastasis
Retrospective Studies
Stomach Neoplasms

Figure

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  Fig. 1 Correlation analysis curve between primary tumor maximum standardized uptake value (SUVmax) and lymph node (LN) SUVmax.

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  Fig. 2 Early gastric cancer in a 47-year-old man. Miaximum intensity projection image of (A) positron emission tomography (PET) and (B) axial PET scan demonstrate focal hypermetabolic lesion in gastric antrum (black arrow) with maximum standardized uptake value (SUVmax) of 4.3. (C) PET/CT scan shows focal hypermtabolic intraluminal mass in posterior wall of gastric antrum (white arrow).

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