Usefulness of Combined PET/CT to Assess Regional Lymph Node Involvement in Gastric Cancer

Abstract

The accuracy of PET/CT is low and it is not a useful tool in the staging of gastric cancer overall in early gastric cancer and in signet-ring-cell carcinoma. Furthermore, the sensitivity of PET/CT could be inferior to that of CECT in the diagnosis of regional lymph node metastasis.

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

“…In this study, the authors reported that PET-CT was superior for detecting primary tumors compared to CT (67 vs. 55 %, p = 0.04). In this study, the proportion of patients with signet ring cell carcinoma was similar to that in our study [16]. In general, signet ring cell carcinoma is less sensitive to PET-CT.…”

“…1c, d). Park et al found both of these imaging methods to be inadequate for detecting regional lymph nodes, when compared with postoperative pathologic results [16]. In another study, there was similar imaging accuracy on PET- CT and CT for detecting lymph node metastases (71.8 and 69.2 %, respectively) [15].…”

“…In general, signet ring cell carcinoma is less sensitive to PET-CT. 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].…”

Urinary kallikrein 10 predicts the incurability of gastric cancer

“…However, it is difficult to diagnose metastasis when the metastatic tumor size is small [2]. It has been reported that CECT sensitivity, specificity, and accuracy for lymph node metastasis (LNM) detection were 25-51%, 79-92%, and 64-72%, respectively [3, 4]. It is sometimes difficult to judge whether a tumor has invaded into an adjacent organ and is unresectable.…”

“…However, FDG-PET/CT did not show additional diagnostic power for LNM compared to CECT where sensitivity, specificity, and accuracy of FDG-PET/CT vs. CECT were 34-41% vs. 51-75%, 88-100% vs. 51-92%, and 51-58% vs. 64-72%, respectively [3, 4]. FDG-PET/CT also showed low sensitivity for peritoneal metastasis [7] and a high detectability of liver and lung metastasis [8], as did CECT.…”