Improving Patient Selection for <sup>18</sup>F-FDG PET Scanning in the Staging of Gastric Cancer

Kaneko, Yui; Murray, William K.; Hicks, Rodney J.; Duong, Cuong

doi:10.2967/jnumed.114.150946

Cited by 42 publications

(45 citation statements)

References 29 publications

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“…It is less detectable with PET-CT evaluation compared to other histological subtypes of gastroesophageal cancer [1,16]. Many factors might affect tumor T stage evaluation on PET-CT, such as tumor size, cell density, tumor origin [17,18]. In the current study, none of the patients had T1 or smaller lesions (\2).…”

Section: Discussionmentioning

confidence: 94%

Concordance of positron emission tomography and computed tomography in patients with locally advanced gastric and esophageal cancer

et al. 2015

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Section: Discussionmentioning

confidence: 94%

Concordance of positron emission tomography and computed tomography in patients with locally advanced gastric and esophageal cancer

et al. 2015

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“…In our study, intestinal-type tumors occurred more frequently in 18 F-FDG-avid than -nonavid tumors, whereas the reverse was true for diffuse-type tumors. Several previous studies showed higher 18 F-FDG uptake intestinal-type than diffuse-type gastric cancers (4,11,21,22). Although the mechanism has not been clearly elucidated, greater mucin content in diffuse-type cancers has been proposed as an explanation for this phenomenon (21).…”

Section: Discussionmentioning

confidence: 97%

“…However, studies to date have shown inconsistent results regarding the performance of 18 F-FDG PET/CT for this purpose (6)(7)(8), and there are concerns that low diagnostic sensitivity may limit its usefulness (9). As such, it would be clinically useful to identify subpopulations of gastric cancer patients who are most likely to benefit from surveillance with 18 F-FDG PET/CT after curative gastrectomy (10,11).…”

mentioning

confidence: 99%

Primary Tumor ¹⁸F-FDG Avidity Affects the Performance of ¹⁸F-FDG PET/CT for Detecting Gastric Cancer Recurrence

et al. 2015

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The usefulness of 18 F-FDG PET in gastric cancer recurrence is limited by low sensitivity. Given that detectability by PET is dependent on the tumor's metabolic characteristics, we tested whether the performance of PET for gastric cancer recurrence is enhanced in patients with 18 F-FDG-avid primary tumors. Methods: Three hundred sixtyeight patients with advanced gastric cancer underwent 18 F-FDG PET/CT for initial staging and for recurrence surveillance after curative surgery. On initial PET/CT, primary tumors were 18 F-FDG-avid if they displayed focal uptake with an SUV max 4 or more. Follow-up 18 F-FDG PET/CT was evaluated for recurrent disease. Results: On initial PET/CT, the primary tumor was 18 F-FDG-avid in 236 of 368 (64.1%) and nonavid in 132 patients (35.9%). During follow-up for 18.9 ± 13.3 mo, 72 patients (19.6%) had recurrence. Of the 63 PET scans with recurrence, 42 (66.7%) and 21 (33.3%) were scans of patients with 18 F-FDG-avid and nonavid primary tumors, respectively. PET sensitivity was higher in scans of patients with 18 F-FDG-avid than nonavid tumors for all recurrences (81.0% vs. 52.4%; P 5 0.018) and nonanastomosis site recurrences (82.1% vs. 47.4%; P 5 0.006). The sensitivity for detecting peritoneal recurrence was also higher for the avid tumor group. PET specificity was similarly high (97.1% and 97.5%) for both groups. Adding cell type and Lauren classification to tumor 18 F-FDG avidity further enhanced PET sensitivity. Conclusion: Surveillance 18 F-FDG PET/CT after resection of gastric cancer has significantly higher sensitivity in patients with 18 F-FDG-avid primary tumors and may have greater value in this group.

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“…Due to histological tumor heterogeneity, different levels of metabolic activity in different stages of disease, and different levels of transporter molecules in cancer cells, the use of FDG-PET-CT did not demonstrate a distinct benefit regarding tumor or lymph node staging compared to standard methods such as CT + EUS. More recent studies indicate that appropriate patient selection can lead to a significant improvement of the accuracy of using FDG-PET-CT for lymph node assessment (27,28). For such patient selection, it seems beneficial to include extra features such as GLUT-1 expression; this glucose transporter molecule is important in gastric cancer glucose metabolism (37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

“…Also, scoring systems that include tumor size, histological subtype, and GLUT-1 immunohistochemical positivity are suggested to improve patient selection for FDG-PET-CT in gastric cancer (27,28). In addition to FDG, 18-fluorothymidine (FLT) has been evaluated as a PET tracer in patients with gastric cancer.…”

Section: Positron Emission Tomography (Pet)mentioning

confidence: 99%

Preoperative staging of nodal status in gastric cancer

Berlth

Chevallay

Jung

et al. 2017

Transl. Gastroenterol. Hepatol.

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An accurate preoperative staging of nodal status is crucial in gastric cancer, because it has a great impact on prognosis and therapeutic decision-making. Different staging methods have been evaluated for gastric cancer in order to predict nodal involvement. So far, no technique could meet the necessary requirements, which include a high detection rate of infiltrated lymph nodes and a low frequency of falsepositive results. This article summarizes different staging methods used to assess lymph node status in patients with gastric cancer, evaluates the evidence, and proposes to establish new methods.

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Improving Patient Selection for ¹⁸F-FDG PET Scanning in the Staging of Gastric Cancer

Cited by 42 publications

References 29 publications

Concordance of positron emission tomography and computed tomography in patients with locally advanced gastric and esophageal cancer

Concordance of positron emission tomography and computed tomography in patients with locally advanced gastric and esophageal cancer

Primary Tumor ¹⁸F-FDG Avidity Affects the Performance of ¹⁸F-FDG PET/CT for Detecting Gastric Cancer Recurrence

Preoperative staging of nodal status in gastric cancer

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Improving Patient Selection for 18F-FDG PET Scanning in the Staging of Gastric Cancer

Cited by 42 publications

References 29 publications

Concordance of positron emission tomography and computed tomography in patients with locally advanced gastric and esophageal cancer

Concordance of positron emission tomography and computed tomography in patients with locally advanced gastric and esophageal cancer

Primary Tumor 18F-FDG Avidity Affects the Performance of 18F-FDG PET/CT for Detecting Gastric Cancer Recurrence

Preoperative staging of nodal status in gastric cancer

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Improving Patient Selection for ¹⁸F-FDG PET Scanning in the Staging of Gastric Cancer

Primary Tumor ¹⁸F-FDG Avidity Affects the Performance of ¹⁸F-FDG PET/CT for Detecting Gastric Cancer Recurrence