Evaluation of FLT-PET/CT usefulness in diagnosis and qualification for surgical treatment of gastric cancer

Abstract

Aim of the studyEvaluation of FLT/PET/ CT usefulness in diagnosis and qualification for surgical treatment of gastric cancer.Material and methodsThe FLT/PET/CT test was carried out in a group of 50 gastric cancer patients. Based on the test result, a decision followed about the therapeutic procedure to be applied. A comparison was made with regards to the consistency of the cancer growth advancement degree evaluation in the initial preoperative FLT/PET/CT test against the evaluation of postoperative degree of cancer advancement in histopathology.ResultsIn the group of 50 diagnosed patients a surgical treatment was used for 37 patients. 21 resections were performed out of which 19 operations were radical In the group of 16 non-resective operations 2 post-laparotomic patients were selected for inductive treatment. In the group of 13 patients who did not undergo any surgery, 10 were directed to palliative care and 3 for inductive treatment. In the group of 50 patients, the applied FLT-PET/CT test confirmed presence of primary tumor in 49 patients. The presence of increased uptake of FLT in the local lymph nodes during the preoperative FLT-PET/CT test was confirmed in 22 cases. In 14 patients with FLT-PET/Ct N(+) with the M(–) feature resection surgery was performed. The increased uptake of FLT in localizing metastases (nodal and non-nodal) FLT-PET/CT (M+) was detected in 22 patients. The presence of nodal metastases in the postoperative histopathology examination (hpN+) was detected in 14 cases. In these cases preoperative FLT-PET/CT test proved the N(+) feature in 11 patients. The result FLT-PET/CT N(–) was truly negative in 2 patients, and false negative in 1 patient. In the group of 7 operated hpN(–) patients, in 3 patients a preoperative result FLT-PET/ CT N(+) (false positive result) was obtained. The consistency (positive) of nodal metastases identification in FLT-PET/CT as compared to post-surgical histopathology examination scored 11/15, which equals 73.3%. In the group of patients in whom resection surgery was performed, 4 false negative results were obtained [hp(N+), FLT-PET/CT (N–)] and 3 false positive results [hp(N–), FLT-PET/CT N(+)].ConclusionsThe initial test results indicate that FLT-PET/CT is an effective method in evaluating the primary tumor and the regional lymph nodes and is useful and beneficial in the diagnosis and further treatment evaluation of gastric cancer. FLT-PET/CT examination facilitates making proper therapeutic decisions – it allows the number of unnecessary laparotomies to be lowered.

Comparability of Diagnostic Methods: Proximal Endoscopy, CT and EUS in Determining Stomach Tumor Localization and their Importance in the Preoperative Analysis of Process Progression

“…We notice that in women representation of grade 3 was slightly higher but due to small sample we could not prove statistical significance. Compared to other researchers such as one by Staniuk T. and associates ( 7 ) which found grade 2 in 12 patients and grade 3 in 13 patients and 25 patients did not specify the grade, we find that more than half of the patients in our group of patients had grade 3.…”

PET/CT for Predicting Occult Lymph Node Metastasis in Gastric Cancer

“…Because 18 F-FDG-PET showed false-positive uptake in areas of inflammation, Nakajo reported that 18 F-FLT-PET showed greater specificity in staging lymph nodes in gastrointestinal tumors compared to 18 F-FDG-PET [ 111 ]. Staniuk [ 112 ] evaluated local lymph node uptake in 22 patients with gastric cancer and identified one patient with micrometastasis. 18 FLT-PET/CT examination confirmed a lymph node metastasis rate of 73%.…”

F18-FLT PET/CT in Patients with Gastric Carcinoma

“…The aim of this evaluation was to compare uptake in normal and cancerous tissue in the stomach. The staging was described in our initial report published in June 2013 [ 5 ].…”