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KMID : 0880420060070040249
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Korean Journal of Radiology
2006 Volume.7 No. 4 p.249 ~ p.256
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Comparison of CT and 18F-FDG PET for Detecting Peritoneal Metastasis on the Preoperative Evaluation for Gastric Carcinoma
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Lim Joon-Seok
Kim Myeong-Jin
Yun Mi-jin
Oh Young-Taik
Kim Joo-Hee
Hwang Hee-Sung
Park Mi-Suk
Cha Seoung-Whan
Lee Jong-Doo
Noh Sung-Hoon
Yoo Hyung-Sik
Kim Ki-Whang
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Abstract
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Objective : The aim of our study was to compare the accuracy of CT and 18F-FDG PET for detecting peritoneal metastasis in patients with gastric carcinoma.
Materials and Methods :One-hundred-twelve patients who underwent a histologic confirmative exam or treatment (laparotomy, n = 107; diagnostic laparoscopy, n = 4; peritoneal washing cytology, n = 1) were retrospectively enrolled. All the patients underwent CT and 18F-FDG PET scanning for their preoperative evaluation. The sensitivities, specificities and accuracies of CT and 18F-FDG PET imaging for the detection of peritoneal metastasis were calculated and then compared using Fisher’s exact probability test (p < 0.05), on the basis of the original preoperative reports. In addition, two board-certified radiologists and two board-certified nuclear medicine physicians independently reviewed the CT and PET scans, respectively. A receiver-operating characteristic curve analysis was performed to compare the diagnostic performance of CT and 18F-FDG PET imaging for detecting peritoneal metastasis.
Results : Based on the original preoperative reports, CT and 18F-FDG PET showed sensitivities of 76.5% and 35.3% (p = 0.037), specificities of 91.6% and 98.9% (p = 0.035), respectively, and equal accuracies of 89.3% (p = 1.0). The receptor operating characteristics curve analysis showed a significantly higher diagnostic performance for CT (Az = 0.878) than for PET (Az = 0.686) (p = 0.004). The interobserver agreement for detecting peritoneal metastasis was good (￥e value = 0.684) for CT and moderate (￥e value = 0.460) for PET.
Conclusion : For the detection of peritoneal metastasis, CT was more sensitive and showed a higher diagnostic performance than PET, although CT had a relatively lower specificity than did PET.
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KEYWORD
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Stomach, neoplasms, Peritoneum, neoplasms, Computed tomography (CT), Positron emission tomography (PET)
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