Japanese Journal of Clinical Oncology Advance Access originally published online on March 5, 2009
Japanese Journal of Clinical Oncology 2009 39(5):297-302; doi:10.1093/jjco/hyp010
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© The Author (2009). Published by Oxford University Press. All rights reserved
Clinical Value of Whole-body FDG-PET for Recurrent Gastric Cancer: A Multicenter Study
1 Department of Diagnostic Radiology, Kyoto University Hospital, Kyoto
2 Department of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Sendai
3 Department of Nuclear Medicine and Radiology, Institute of Development Aging and Cancer, Tohoku University, Sendai
4 Department of Radiology, Hitachi General Hospital, Hitachi
5 PET Center, Dokkyo Medical University, Tochigi
6 Functional Imaging Division, National Cancer Center Hospital East, Kashiwa
7 Radiology Division, National Cancer Center Hospital East, Chiba
8 Department of Radiology, Yokohama City University School of Medicine, Yokohama
9 Division of Nuclear Medicine, Department of Radiology, International Medical Center of Japan and Tokyo
10 Division of Molecular Imaging, Institute of Biomedical Research and Innovation, Kobe, Japan
For reprints and all correspondence: Yuji Nakamoto, Department of Diagnostic Radiology, Kyoto University Hospital, 54 Shogoinkawahara, Sakyo-Ku, Kyoto 606-8507, Japan. E-mail: ynakamo1{at}kuhp.kyoto-u.ac.jp
Received October 1, 2008; accepted January 19, 2009
Objective: The purpose of this multicenter study was to evaluate the clinical usefulness of positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) for suspected recurrent gastric cancer.
Methods: We performed a retrospective review of 92 consecutive patients who underwent PET [either integrated PET/computed tomography (CT) or manual fusion of dedicated PET and CT] scans for post-treatment surveillance of gastric cancer between June 2006 and December 2007. Of these patients, 46 patients were suspected of recurrence by other imaging modalities (Group A), 19 patients were suspected of recurrence by tumor markers without definite findings (Group B) and the remaining 27 patients underwent a PET scan without evidence of recurrence (Group C). The diagnostic performance and prevalence of the clinical impact of FDG-PET were analyzed.
Results: Recurrence of gastric cancer was confirmed in 31 patients (67%) in Group A, in 11 patients (58%) in Group B and in 2 patients (7%) in Group C. In addition, colon cancer (n = 3), lung cancer (n = 1) and pulmonary carcinoid (n = 1) were identified in five patients (5%). In patient-basis, the sensitivity, specificity and diagnostic accuracy of PET for recurrence were 81%, 87% and 83%, respectively, in Group A, 73%, 88% and 79%, respectively, in Group B and 50%, 88% and 85%, respectively, in Group C. Therapeutic management was influenced by PET results in 22 patients (48%) in Group A, in 8 patients (42%) in Group B and in 2 patients (7%) in Group C, including cases in which PET was helpful for detecting second primary cancer.
Conclusions: PET with FDG yielded useful information in patients with suspected recurrent gastric cancer, especially when recurrence was suspected in the clinical setting.
Key Words: 18F-FDG • PET • gastric cancer • recurrence