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KMID : 0614620120590050347
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Korean Journal of Gastroenterology
2012 Volume.59 No. 5 p.347 ~ p.353
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Usefulness of 18F-fluoro-2-deoxyglucose Positron Emission Tomography in Evaluation of Gastric Cancer Stage
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Yoon Na-Ri
Park Jae-Myung
Jeong Hee-Sun
Cho Yu-Kyung
Lee In-Seok
Choi Myung-Gyu
Chung In-Sik
Song Kyo-Young
Park Cho-Hyun
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Abstract
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Background/Aims: The usefulness of 18F-fluoro-2-deoxyglucose (FDG)-PET in detecting primary cancer, lymph node metastasis, and distant metastasis were studied in the gastric cancer patients.
Methods: The subjects were 392 gastric cancer patients who received FDG-PET and an abdominal CT test prior to surgery. The results of FDG-PET and CT were compared with the surgical and pathologic results.
Results: The primary site detection rate of FDG-PET was 74.4%, 50.3% in early gastric cancer and 92.0% in advanced gastric cancer. Detection rate was higher when tumors were larger than 3.5 cm, had deeper depth of invasion, and at a later stage (p<0.05, respectively). In multivariate analysis, tumor size, spread of tumor cells beyond the muscle layer (≥T2), and lymph node metastasis were statistically significant factors in primary site detection rate. The sensitivity, specificity, and positive predictive value of FDG-PET to lymph node metastasis were 59.6%, 88.8%, and 81.1% respectively, sensitivity being lower compared to CT while specificity and positive predictive value were higher. Sensitivity, specificity, and positive predictive value to distant metastasis were, respectively, 66.7%, 99.2%, and 88.0%, similar to CT. In 21 of the 392 patients (5.4%), synchronous double primary cancers were detected.
Conclusions: In gastric cancer, usefullness of FDG-PET is limited to the advanced stage. Diagnostic value of this test was not superior to CT. However, FDG-PET may be useful in detecting synchronous double primary cancers. (Korean J Gastroenterol 2012;59:347-353)
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KEYWORD
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Stomach neoplasms, Fluorodeoxyglucose F18, Positron-emission tomography, Lymph nodes, Neoplasm metastasis
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