Assessment of (18)F-fluorodeoxyglucose positron emission tomography combined with computed tomography in the preoperative management of patients with gastric cancer

Int J Clin Oncol. 2014 Aug;19(4):649-55. doi: 10.1007/s10147-013-0598-6. Epub 2013 Jul 24.

Abstract

Background: The significance of (18)F-2-deoxy-2-fluoro-glucose positron emission tomography combined with computed tomography imaging (FDG-PET/CT) in the diagnosis of gastric cancer remains controversial. This study aimed to evaluate the efficacy of preoperative FDG-PET/CT in staging of gastric cancer.

Methods: FDG-PET/CT results for 90 patients with gastric cancer were retrospectively examined. For quantitative PET analysis, FDG uptake was assessed based on the maximum standardized uptake values (SUVmax).

Results: FDG-PET/CT detected the primary gastric cancer in 71 of the 90 patients (sensitivity 78.9 %). The median SUVmax was significantly higher in patients with T3/T4 disease than in those with T1/T2 (9.0 vs. 3.8; P < 0.001), in patients with distant metastasis than in those with no metastasis (9.5 vs. 7.7; P = 0.018), and with stage III/IV tumors than in those with stage I/II (9.0 vs. 4.7; P = 0.017). The SUVmax of the primary tumor was significantly correlated with tumor size (r = 0.461, P < 0.001). The sensitivity, specificity, and accuracy of FDG-PET/CT in assessing metastasis to regional lymph nodes were 64.5, 85.7, and 71.1 %, respectively.

Conclusions: FDG-PET/CT results are significantly associated with tumor progression in gastric cancer, and such findings can reliably identify cancer cell populations.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18*
  • Gastrectomy
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Preoperative Period
  • Radiography
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery
  • Tomography Scanners, X-Ray Computed*

Substances

  • Fluorodeoxyglucose F18