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

Sun, Long; X, Su; Guan, Yong-Song; Pan, Wei-Ming; Luo, Zun-Chang; Wei, Jihong; Wu, Hua

doi:10.3748/wjg.14.4627

Cited by 45 publications

(31 citation statements)

References 27 publications

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“…Sun et al [33] evaluated the clinical role of PET/CT in the detection of gastric cancer recurrence after initial surgical resection in 23 patients. Overall, the accuracy of PET/CT was 83%, NPV was 78%, and PPV was 86%.…”

Section: Utility Of Pet In Detecting Recurrent Gastric Cancermentioning

confidence: 99%

Japanese Gastric Cancer Association Task Force for Research Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature

et al. 2011

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Since April 2010, the Japanese Public Health Insurance System has covered the costs incurred for performing 18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) imaging for patients with advanced gastric cancer. The aim of this review was to evaluate the clinical impact of PET for patients with gastric cancer. A systematic literature search was performed in PubMed/MEDLINE using the keywords ''gastric cancer'' and ''PET'' to search for relevant articles published from January 2000 to September 2010. The clinical impact of selected articles was assessed by the authors to evaluate the following: (a) tumor staging, (b) diagnosis for recurrent disease, (c) evaluation of treatment response, and (d) screening for gastric cancer. FDG uptake increases in papillary adenocarcinoma, tubular adenocarcinoma, and solid-type poorly differentiated adenocarcinoma. This uptake is also associated with glucose transporter 1 expression. The sensitivity and specificity of FDG-PET for metastatic lymph node detection were 21-40% and 89-100%, respectively. The sensitivity and specificity for distant metastasis detection were 35-74% and 74-99%, respectively. Treatment response can be detectable at an earlier stage by PET than by computed tomography (CT), because FDG uptake by cancer cells decreases according to the treatment response. In summary, although PET has limitations such as frequent false-negative cases in signetring cell carcinoma and non-solid type poorly differentiated carcinoma, it can contribute to the selection of a more appropriate treatment modality by detecting distant metastases and treatment response.

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Section: Utility Of Pet In Detecting Recurrent Gastric Cancermentioning

confidence: 99%

Japanese Gastric Cancer Association Task Force for Research Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature

et al. 2011

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“…Therefore, evaluation of the anastomotic site of gastroduodenostomy in the remnant stomach is important for detection of locoregional recurrence of gastric cancer. No available data focus on the anastomotic site, and the reported studies of FDG PET/CT for detecting gastric cancer recurrence focused only on the focal increased F-18 FDG uptake lesion relative to the normal biodistribution of background F-18 FDG uptake in the remnant stomach [3,6,8,12,19,25].…”

Section: Discussionmentioning

confidence: 99%

“…The primary curative therapy for early and advanced gastric cancer is radical surgery [1,[6][7][8]. Total gastrectomy is commonly performed for advanced gastric cancer of the proximal or middle third of the stomach, while subtotal gastrectomy is preferred for patients with distal gastric cancer because no survival benefit has been proven for total gastrectomy [9].…”

Section: Introductionmentioning

confidence: 99%

“…It is generally accepted that integrated PET/CT provides superior performance in the evaluation of a malignancy compared to PET or CT alone [12,19]. Several FDG PET and PET/CT studies have reported variable FDG uptake of primary gastric malignancies according to their histological subtypes [6]. However, only a few studies have been reported regarding the use of PET in recurrent gastric cancer [2,6,12,19].…”

Section: Introductionmentioning

confidence: 99%

“…Several FDG PET and PET/CT studies have reported variable FDG uptake of primary gastric malignancies according to their histological subtypes [6]. However, only a few studies have been reported regarding the use of PET in recurrent gastric cancer [2,6,12,19]. In addition, no reports have focused on the anastomotic site, the most common site of local recurrence [5], with F-18 FDG PET/CT.…”

Section: Introductionmentioning

confidence: 99%

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Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer

Choi

Zeon

Kim

et al. 2011

Nucl Med Mol Imaging

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Purpose The aim of this study was to characterize the patterns of fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography/computed tomography (FDG PET/CT) at the anastomotic site of gastroduodenostomy after distal subtotal gastrectomy in patients with gastric cancer. Methods From May 2007 to May 2010, two or more follow-up measurements using FDG PET/CT scans were done for 19 patients (11 men, 8 women; mean age, 62.0± 10.3 years) who underwent distal subtotal gastrectomy with gastroduodenostomy between February 2006 and March 2008 for detecting gastric cancer recurrence at our medical center. The FDG PET/CT images were retrospectively reviewed. Patients with local recurrence, regional nodal metastasis or distant metastasis on follow-up studies were excluded. CT and endoscopy were done within 1 month before or after the FDG PET/CT scan. Eight patients had two follow-ups of FDG PET/CT, and 11 patients had three follow-ups. The mean interval between surgery and the first follow-up FDG PET/CT was 12.9±0.8 months (n=19); between the first and second it was 12.3±1.0 months (n= 19); between the second and third it was 11.6±0.7 months (n=11). The F-18 FDG uptakes at the anastomotic site and fundus in the remnant stomach were measured by maximum standardized uptake value (SUVmax) using a region of interest technique.Results The SUVmax at the anastomotic site was significantly higher than that of the fundus on all series of first, second and third follow-up studies (3.3±1.1 vs. 2.1±0.7, p<0.001: 3.1±0.9 vs. 2.2±0.7, p=0.001: 3.0±0.6 vs. 2.1±0.7, p=0.006, respectively). The SUVmax for the anastomotic site and fundus, and SUVmax ratio for the anastomotic site over the fundus were not significantly different throughout the series. Conclusion The SUVmax at the anastomotic site is significantly higher than that of the fundus and does not decrease significantly over time. Therefore, the local recurrence of gastric cancer after surgery could not be definitely differentiated from physiologic uptake or postoperative inflammatory change.

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Evidence-Based Positron Emission Tomography

Choi

2012

Clinical PET and PET/CT

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progression in Deauville score 3 (40/60, 67%) was significantly different from score 2 (21/47, 45%; P = 0.023) and 4 (24/27, 89%; P = 0.030), we categorized patients into 3 groups: Deauville score 1-2, 3, and 4-5. With a median follow-up of 54.7 months (IQR, 30.2-84.5), 5-year PFS rate was 35.7% (95% CI, 30.0-41.4), and OS rate was 47.1% (95% CI, 40.8-53.4). NCCN-IPI risk and post-treatment PET-CT scan were independently associated with PFS in multivariate analysis (for LI NCCN-IPI, hazard ratio [HR] 1.615, 95% CI 0.838-3.113; HI NCCN-IPI, HR 3.063, 95% CI 1.626-5.769; high NCCN-IPI 4.475, 95% CI 2.231-8.977; P < 0.001: for post-treatment Deauville score 3, HR 1.895, 95% CI 1.281-2.801; score 4-5, HR 6.916, 95% CI 4.948-9.667; P < 0.001). We stratified patients into 5 groups based on risk of progression: low (low NCCN-IPI and Deauville score 1-2), INT-1 (low NCCN-IPI and score 3, or LI NCCN-IPI and score 1-2), INT-2 (HI NCCN-IPI and score 1-2), high (high NCCN-IPI and score 1-2, or LI to high NCCN-IPI and score 3), and very high (score 4-5). The risk model showed a strong association with PFS and OS (Figure 1). Conclusion: This study proposes a new risk stratification model incorporating baseline NCCN-IPI in combination with post-treatment Deauville score on PET-CT scan in patients with newly diagnosed nodal PTCL.

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

Cited by 45 publications

References 27 publications

Japanese Gastric Cancer Association Task Force for Research Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature

Japanese Gastric Cancer Association Task Force for Research Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature

Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer

Evidence-Based Positron Emission Tomography

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