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Lymph Node Staging of Gastric Cancer Using 18F-FDG PET: A Comparison Study with CT

Mijin Yun, MD1, Joon Seok Lim, MD2, Sung Hoon Noh, MD3, Woo Jin Hyung, MD3, Jae Ho Cheong, MD3, Jung Kyun Bong, PhD1, Arthur Cho, MD1 and Jong Doo Lee, MD1

1 Division of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea
2 Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea
3 Department of Surgery, Yonsei University College of Medicine, Seoul, Korea



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FIGURE 1. EGC, Bormann type I. PET images demonstrate focus of increased 18F-FDG uptake on sagittal (A) and axial (B) views, and CT shows protruding mass (arrow) (C) in posterior wall of antrum of stomach.

 


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FIGURE 2. Patient with AGC and pathologically proven N1 metastasis. (A) 18F-FDG PET shows mass with increased 18F-FDG uptake in body of stomach without perigastric lymph node metastasis. (B) Perigastric lymph node (arrow) is noted on CT. Sensitivity of CT is significantly higher than that of PET for N1 disease.

 


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FIGURE 3. N2 metastasis (arrow) in region of common hepatic artery on 18F-FDG PET sagittal (A) and axial (B) views and on CT (C). For N2 disease, CT appears to be more sensitive than PET, whereas PET appears more specific than CT.

 


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FIGURE 4. Two N3 metastases (arrows) in left paraaortic space on 18F-FDG PET (A) and CT (B). Both PET and CT are insensitive but highly specific for N3 disease.

 





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