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KMID : 0914820010010030174
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Journal of the Korean Gastric Cancer Association
2001 Volume.1 No. 3 p.174 ~ p.179
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Usefulness of a FDG-PET Scan in Assessing Recurrent Gastric Cancer
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Lee Hyeon-Kook
Lee Kyu-Eun
Kim Yoon-Ho
Jeong Jae-Min
Yang Han-Kwang
Chung June-Key
Lee Kuhn-Uk
Choi Kook-Jin
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Abstract
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Purpose: For curative resection of recurrent gastric cancer, it is imperative that there be no unrecognized foci of tumoral disease outside the operation field. PET (positron emission tomography) with FDG (18 fluoro-2 deoxy-D-glucose) is a whole-body imaging technique that exploits the increased rate of glycolysis in tumor cells to detect disease. The authors evaluated the usefulness of FDG-PET in assessing resectability of recurrent gastric cancer.
Materials and Methods: Seven patients with recurrent gastric cancer were studied with FDG-PET from December 1998 to October 2000. All FDG-PET images were interpreted in conjunction with conventional diagnostic methods. All imaging results were correlated with the pathological diagnosis and clinical outcome.
Results: A final diagnosis of recurrence was obtained at 14 sites in all 7 patients by histology or clinical follow up. Locoregional recurrence, including distant metastasis, developed in 6 of 7 patients and distant recurrence in only one. FDG-PET detected all recurrent sites (5 locoregional and 5 distant) in 5 patients without peritoneal recurrence, but did not detect peritoneal seeding in 2 patients with peritoneal recurrence. The accuracy of FDG-PET in estimating resectability was 71.4% (5/7), and that of CT and PET together was 85.7% (6/7). A curative resection could be performedin three of the recurrent patients (2 locoregional and 1 distant recurrence).
Conclusion: Our results suggest that FDG-PET may be useful for detecting locoregional and distant recurrence of gastric cancer and for selecting appropriate treatment. However, considering that FDG-PET was limited in detecting peritoneal seeding and determining the exact anatomical extension of tumor, it should be used in conjunction with other anatomical images.
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KEYWORD
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Recurrent gastric cancer, FDG-PET
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