Significance of 18F-2-deoxy-2-fluoro-glucose accumulation in the stomach on positron emission tomography

Abstract

Accumulation of (18)FDG in the stomach suggests a high probability of the presence of inflammatory change in the gastric mucosa forming a background for the development of cancer or malignant lymphoma, and thus requires further endoscopic examinations.

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

“…They concluded that elevated esophagogastric FDG uptake does not predict cancer development and should not be investigated further if CT shows no unusual features. Takahashi et al [5] reported the association between the endoscopic view, Helicobacter pylori infection, and FDG accumulation in 272 patients who underwent a PET examination during a health check-up. They found FDG accumulation in 81 cases (30%), which they classified according to the following 2 patterns: (a) localized accumulation only in the fornix (Group A, n = 32) and (b) diffused accumulation throughout the stomach (Group B, n = 49).…”

“…For gastric cancer screening, the usefulness of PET is limited because of physiological FDG uptake in the normal gastric wall and differences of FDG uptake according to the histological type of the tumor [1,2]. Physiological FDG deposits in the stomach may increase false-positive findings, although these deposits can be decreased by expanding the gastric wall by the patient consuming water or milk just before imaging acquisition [4,5]. As Koga et al [2] have reported, physiological gastric FDG uptake was shown to be significantly higher at the oral end; thus, strong gastric FDG uptake at the anal end suggested pathological uptake.…”

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

“…The same is true for the remnant stomach in subtotal gastrectomy patients [8]. Accumulation of F-18 FDG in the gastrointestinal smooth muscle due to accelerated gastric peristalsis or inflammatory changes have been suggested as possible causes for physiological and diffuse F-18 FDG uptake in the remnant stomach [23]. Also, the mechanism is not clear.…”

“…Also, the mechanism is not clear. Several studies suggested that specific or non-specific gastritis is one of the causes of diffuse F-18 FDG uptake in the stomach, and these findings have a positive relationship with Helicobacter pylori infection [23,24]. Yun et al [8] reported that gastric distension due to ingestion of a glass of water is an effective way to diagnose in a patient with suspected gastric tumor recurrence.…”

“…[22,26]. Increased F-18 FDG uptake in inflammatory and infectious lesions is well established [23,27,28]. It is well documented that patients with a gastroduodenostomy have reflux of duodenal contents into the remnant stomach due to the absence of the pyloric sphincter, leading to gastritis [14,17].…”