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The Study of FDG-PET/CT Sensitivity for Gastric Cancer
Kiyoshi Kawaguchi*1, Masahiro Urayama1, Makoto Toda1, Hideki Isobe1, Toshiyuki Moriya2, Keiji Ohta1, Akira Fuse1
1Surgery, Yamagata Saisei hospital, Yamagata, Japan; 2Surgery, Okitama Public General Hospital, Kawanishi-Machi, Japan
Background: FDG-PET/CT was effective tool to detect malignant tumor, however there were a few FDG-PET/CT studies for gastric cancer (GC).
Objective: To examine the sensitivity of preoperative FDG-PET/CT for GC.
Method: We retrospectively reviewed the clinical records of 65 patients who underwent gastrectomy with lymphnodes (LNs) dissection for GC between 2004 and 2012. The sensitivity of FDG-PET/CT for GC were determined from the results of FDG-PET/CT and pathological findings of resected GC specimens.
Result: In primary cancer the sensitivity of FDG-PET/CT was 21% (3/14) in early GC and 82% (40/51) in advanced GC (early vs. advanced cancer, p<0.01). The range of standardized uptake value was between 3.4 and 32. The sensitivity was 68% (26/38) in well-differentiated adenocarcinomas and 48% (13/27) in poorly-differentiated adenocarcinomas. In metastatic LN, the positive FDG-PET/CT findings were detected in 10 of 26 patients who were proven LN metastases in histological examination (38%). Total 185 LNs were proven to histological cancer positive, of which 18 LNs were identified accurate site of metastatic region by FDG-PET/CT (10%). In these 18 metastatic LNs detected by FDG-PET/CT, 16/18 (89%) LNs were larger than 10mm in diameter. Distant metastatic LNs less than 8mm in diameter were identified, although the metastatic LNs which were next to FDG positive primary lesion were not identified. There were no positive findings FDG-PET/CT in 4 patients with peritoneal dissemination.
Conclusion: Sensitivity of FDG-PET/CT was high for primary lesion of advanced GC but low for early GC, LN metastases, and peritoneal dissemination.
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