Korean J Gastroenterol.  2016 Apr;67(4):183-188. 10.4166/kjg.2016.67.4.183.

Efficacy of Positron Emission Tomography/Computed Tomography in Gastric Mucosa-associated Lymphoid Tissue Lymphoma

• Hwang JW
• Jee SR
• Lee SH
• Kim JH
• Seol SY
• Lee SM

• KMID: 2373423
• DOI: http://doi.org/10.4166/kjg.2016.67.4.183

Abstract

BACKGROUND/AIMS
This study evaluated the diagnostic efficacy of fluorine-18 fluorodeoxyglucose PET/CT (F-18 FDG PET/CT) for patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma and examined the association between FDG avidity and the clinical factors affecting lesions.
METHODS
Among the patients diagnosed with gastric MALT lymphoma, 16 who underwent a PET/CT for gastric MALT lymphoma were semi-quantitatively and qualitatively tested for FDG avidity of lesions in the stomach. Retrospectively collected data was analyzed to investigate the clinicoradiological factors and endoscopic findings between the patients with positive F-18 FDG PET/CT scans and those with negative scans.
RESULTS
Eight of the 16 patients showed FDG avidity. When comparing the size of lesions in the stomach, the patients with FDG avidity had significantly larger lesions than those without (28.8 mm vs. 15.0 mm, p=0.03). The FDG-avid group has a significantly higher rate of positive CT scans than the non-avid group (75% vs. 13%, p=0.03). According to the endoscopic finding of the lesions, FDG avidity was pronounced with 75% of the protruding tumors, and 100% of the erosive-ulcerative types, which are a type of depressed tumors.
CONCLUSIONS
When gastric MALT lymphoma is large, when lesions are found using abdominal CT scans, and the macroscopic appearance of a lesion is that of a protruding tumor or erosive-ulcerative type of depressed tumor, there is a high probability that such patients may have a positive F-18 FDG PET/CT scan.

Keyword

Positron emission tomography; Stomach; Lymphoma, B-cell, marginal zone

MeSH Terms

Aged
Female
Fluorodeoxyglucose F18/chemistry/metabolism
Gastroscopy
Humans
Lymphoma, B-Cell, Marginal Zone/*diagnosis/diagnostic imaging
Male
Middle Aged
Positron Emission Tomography Computed Tomography
Retrospective Studies
Stomach Neoplasms/diagnostic imaging/metabolism
Fluorodeoxyglucose F18

Figure

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  Fig. 1. Flowchart shows patient inclusion. MALT, mucosa-associated lymphoid tissue; F-18 FDG, fluorine-18 fluorodeoxyglucose.

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  Fig. 2. This case shows the fluorine-18 fluorodeoxyglucose (F-18 FDG) uptake in an erosive-ulcerative type of gastric mucosa-associated lymphoid tissue lymphoma. (A) A 56-year-old female patient had an erosive-ulcerative lesion on the antral posterior wall of the stomach. (B) Maximum standardized uptake value of F-18 FDG uptake (arrow) was 6.2. (C) Abdomen CT shows irregular wall thickening at the gastric antrum.

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  Fig. 3. This case shows no fluorine-18 fluorodeoxyglucose (F-18 FDG) uptake in a discolored-scar type of gastric mucosa-associated lymphoid tissue lymphoma. (A) A 53-year-old male patient had a discolored-scar lesion on the greater curvature in lower body of the stomach. (B) F-18 FDG PET revealed no significant F-18 FDG uptake in the stomach. (C) Abdomen CT shows no wall thickening at the gastric body.

Reference

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