HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yoshioka, T. Articles by Kanamaru, R. Search for Related Content PubMed PubMed Citation Articles by Yoshioka, T. Articles by Kanamaru, R.

Evaluation of ¹⁸F-FDG PET in Patients with Advanced, Metastatic, or Recurrent Gastric Cancer

¹ Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
² Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
³ Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
⁴ Department of Diagnostic Radiology, Tohoku University Hospital, Tohoku University, Sendai, Japan

View larger version (26K): [in a new window]   FIGURE 1. ROC curves for sites of primary lesions (A), liver (B), lymph node (C), and lung (D) metastases. SET = SET2400W; 931 = PT931/04. Each curve reflects high detectability of these lesions.

View larger version (24K): [in a new window]   FIGURE 2. ROC curves for lesions of peritonitis carcinomatosis (A), ascites (B), pleuritis carcinomatosis (C), and bone metastases (D). SET = SET2400W; 931 = PT931/04. Each curve reflects low detectability of these lesions.

View larger version (124K): [in a new window]   FIGURE 3. Cases with primary lesions. (A) Borrmann type II lesion with liver, lymph node metastases, and pleuritis carcinomatosis (patient S19). Primary lesion is shown as elevated mass with rolled margin on barium radiograph image (arrows, a), accompanying large central ulceration in endoscopic image (arrows, b). Low-density area of 5 mm in diameter in liver (arrow, c) and pleural effusion (arrow, d) are evident on CT image. They have been proven to be liver metastasis and pleuritis carcinomatosis in clinical course. CT image also shows abdominal lymph node metastases. Primary lesion (arrows, e), liver (arrows, f), and abdominal lymph node metastases (arrows, g) are clearly visualized by 18F-FDG PET but pleuritis carcinomatosa is not. (B) Borrmann type III lesion with abdominal, cervical lymph node metastases, and peritonitis and pleuritis carcinomatosis and ascites (patient S15). Endoscopic image shows ulcerated lesion (arrow, h) and infiltration to gastric mucosa (arrows, i). CT images show cervical and abdominal lymph node metastases. They also show pleural effusion and ascites that were diagnosed as malignancy by cytology. Primary lesion (arrows, j), cervical lymph node (arrow, k), and abdominal lymph nodes (arrows, l) are detected by 18F-FDG PET, but no findings indicate peritonitis and pleuritis carcinomatosis or ascites. (C) Borrmann type IV lesion with peritonitis carcinomatosis and ascites (patient S14). Barium radiographic image shows hard wall of stomach without extension (arrows, m), and endoscopic image shows diffusely thickening folds (arrows, n). CT images show thickening wall of stomach and small amount of ascites in pelvis. Patient had undergone exploratory laparotomy that revealed dissemination of small nodal lesions in peritoneum. 18F-FDG PET indicates no findings of Borrmann IV lesion, peritonitis carcinomatosis, or ascites.

View larger version (80K): [in a new window]   FIGURE 4. Borrmann type V lesions with multiple bone metastases. On endoscopic images, primary lesion is shown as scirrhous infiltration (arrows, a) accompanying some ulcerated areas (arrows, b). 18F-FDG demonstrates hot foci (arrows, c) corresponding to ulcerated areas. On images of bone scintigraphy, there are many hot spots corresponding to metastases on skull, scapula, vertebrae, costae, and sternum, but 18F-FDG PET image suggests bone metastases only in sternum (arrows, d) and part of scapula (arrow, e) and vertebrae (arrows, f).

View larger version (64K): [in a new window]   FIGURE 5. Cases with peritonitis or pleuritis carcinomatosis. (A) Recurrence to peritoneal and thoracic cavities after total gastrectomy (patient S09). CT images show large amount of pleural effusion and ascites that were diagnosed as malignancy by cytology, but 18F-FDG PET shows no findings. (B) Borrmann type III lesion with peritonitis carcinomatosis (patient S05). Barium radiographic image shows pyrolic stenosis (arrows, a). CT images show large amount of ascites and nodal masses on peritoneal wall (arrows, b). 18F-FDG accumulates in sites corresponding to primary lesion (arrows, c) and nodal masses (arrows, d) on peritoneal wall.

View larger version (14K): [in a new window]   FIGURE 6. SUVs of each lesion. Prim = primary lesions (); Liver = liver metastases (•); Lym = lymph node metastases (); Bone = bone metastases (); Abd w. = abdominal wall tumors (); Lung = lung metastases ( ). SUVs are 8.9 ± 4.2, 6.5 ± 2.2, 6.1 ± 2.5, 3.9 ± 2.0, 6.5 ± 1.8, and 4.7 ± 2.6, respectively. SUVs of primary lesions, liver, and lymph node metastases involve data from 2 patients who had prior chemotherapy. SUVs from patients who were chemotherapy naive are given in Table 4. SUVs of bone, abdominal wall, and lung metastases are all from patients who were chemotherapy naive.

View larger version (20K): [in a new window]   TABLE 4