Clinical role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in post-operative follow up of gastric cancer： Initial results

AIM： To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography （18F-FDG PET/CT） in detection of gastric cancer recurrence after initial surgical resection. METHODS： In the period from January 2007 to May 2008, 23 patients who had previous surgical resection o...

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Published in:World journal of gastroenterology : WJG 2008-08, Vol.14 (29), p.4627-4632
Main Authors: Sun, Long, Su, Xin-Hui, Guan, Yong-Song, Pan, Wei-Ming, Luo, Zuo-Ming, Wei, Ji-Hong, Wu, Hua
Format: Article
Language:English
Subjects:
18F-氟去氧葡萄糖
Adenocarcinoma - diagnostic imaging
Adenocarcinoma - surgery
Female
Fluorodeoxyglucose F18
Follow-Up Studies
Gastric Cancer
Humans
Male
Middle Aged
Neoplasm Recurrence, Local - diagnostic imaging
Positron-Emission Tomography - methods
Predictive Value of Tests
Radiopharmaceuticals
Retrospective Studies
Stomach Neoplasms - diagnostic imaging
Stomach Neoplasms - surgery
Tomography, X-Ray Computed - methods
X线检查
正电子
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Summary:AIM： To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography （18F-FDG PET/CT） in detection of gastric cancer recurrence after initial surgical resection. METHODS： In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations. RESULTS： PET/CT was positive in 14 patients （61%） and negative in 9 （39%）. When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients （35%） and by clinical follow-up in 15 （65%）, PET/CT was true positive in 12 patients, false positive in 2, true negative in 8 and false negative in 2. Overall, the accuracy of PET/CT was 82.6%, the negative predictive value （NPV） was 77.7%, and the positive predictive value （PPV） was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negativePET/CT, the f inal diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly, PET/CT revealed true-positive findings in 11 （47.8%） patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in one patient. Clinical treatment decisions were changed in 7 （30.4%） patients after introducing PET/CT into their conventional post-operative follow-up program. CONCLUSION： Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.14.4627