Value of 18F-FDG PET/CT for differentiating diagnosis between malignant and benign primary gastric gastrointestinal mesenchymal tumors: a single-center retrospective study

Li, Shengxu; Lin, Duanyu; Tang, Mingdeng; Daojia, Liu; Lyu, Qinghu; Zhang, Jieping

doi:10.21037/jgo-22-287

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…FDG PET/CT findings of adenocarcinoma arising from heterotopic pancreas have been rarely reported 10 . This case indicates that heterotopic pancreatic adenocarcinoma should be included in the differential diagnosis of FDG-avid gastric submucosal lesions including gastrointestinal stromal tumor, 11 lymphoma, 12 neuroendocrine tumor, 13 metastasis, 14,15 schwannoma, 16 inflammatory fibroid polyp, 17 xanthogranulomatous gastritis, 18 IgG4-related disease, 19 and heterotopic pancreas 6–9 . Elevation of serum carbohydrate antigen 19-9 level may be helpful for the diagnosis because approximately 57% of patients with heterotopic pancreatic adenocarcinoma have an increased level of serum carbohydrate antigen 19-9 4 …”

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confidence: 78%

FDG PET/CT in Pancreatic Ductal Adenocarcinoma Arising From a Heterotopic Pancreas of the Pylorus

Ji,

Dong,

Wang

2023

Clin Nucl Med

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Malignant transformation of heterotopic pancreas is extremely rare. We describe FDG PET/CT findings in a case of pancreatic ductal adenocarcinoma arising from a heterotopic pancreas in the submucosa of the pylorus with peripyloric lymph node metastasis and elevated serum carbohydrate antigen 19-9 level. The heterotopic pancreatic adenocarcinoma showed intense FDG uptake, and the peripyloric lymph node metastasis showed mild FDG uptake. This case indicates that heterotopic pancreatic adenocarcinoma should be included in the differential diagnosis of FDG-avid gastric submucosal lesions, especially in patients with elevated serum carbohydrate antigen 19-9 level.

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confidence: 78%

FDG PET/CT in Pancreatic Ductal Adenocarcinoma Arising From a Heterotopic Pancreas of the Pylorus

Ji,

Dong,

Wang

2023

Clin Nucl Med

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“…Due to the diversity and complexity of the biological behavior of GIST, it cannot be classified solely as benign or malignant; the risk of GIST biological behavior can be quickly and effectively judged by examining the patient's treatment plan and prognosis, as it is closely related to these [4,5]. 18 F-FDG metabolic imaging reflects the level of glucose metabolism of tumors, which is positively correlated with the risk of the tumors [6,7].…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of 18F-FDG PET/CT imaging in 32 cases of gastrointestinal stromal tumors

et al. 2022

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Objectives To explore the clinical significance of 18F-FDG metabolic imaging in the diagnosis and biological risk assessment of gastrointestinal stromal tumors (GIST). Methods This study is a clinical retrospective study. The research subjects were patients with GIST who were admitted to our hospital from January 2014 to December 2019 and underwent 18F-FDG metabolic imaging, and the relationship between biological risk and FDG metabolism was analyzed retrospectively. Results A total of 32 patients with GIST were included in this study, of which 17 patients had very low and low-risk lesions, and the FDG metabolism level did not increase; five patients had moderate-risk gastric lesions, and the FDG metabolism level was abnormally increased; 10 patients had high-risk lesions, and except for one patient with multiple lesions, the FDG metabolism level of these patients was increased. Conclusions The level of glucose metabolism is abnormally increased in tumor cells with vigorous mitosis and has higher biological risk. The 18F-FDG metabolism level can determine the biological risk of GIST and whether high-risk lesions involve other tissues and organs, as it more comprehensively reflects the distribution of lesions, the activity of tumor cells and the stage of the disease.

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“…Magnetic resonance imaging (MRI) is considered the primary imaging modality of choice in evaluating liver metastasis because of its superior soft-tissue contrast and direct multiplanar acquisition capability, and the lack of exposure to ionizing radiation (14). MRI and 18 F-FDG PET/CT have proven valuable in the assessment of malignant potential, response to treatment after targeted therapy, detecting tumor recurrence, and evaluation of prognosis in GIST (15)(16)(17)(18)(19)(20). While there has been much focus on the management, treatment response, and prognosis of GIST liver metastasis (21)(22)(23), few studies have examined the imaging features of GIST liver metastases, especially using functional imaging.…”

Section: Introductionmentioning

confidence: 99%

18F-FDG PET/CT and MR imaging features of liver metastases in gastrointestinal stromal tumors: a cross-sectional analysis

Lyu¹,

Lin²,

Tang³

et al. 2022

Ann Transl Med

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Background: Early detection of gastrointestinal stromal tumor (GIST) liver metastases is crucial for the management and prognosis. In our experience, GIST liver metastases can display hypermetabolism on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and marked enhancement on magnetic resonance imaging (MRI), which are uncommon in other tumors before treatment. Most literature focus on the imaging evaluation, prognosis after treatment and less is known about imaging features on both imaging methods before treatment. This study analyzes the imaging features of newly diagnosed GIST liver metastases on 18 F-FDG PET/CT and MRI, with goal of improving diagnostic accuracy.Methods: This retrospective study included 55 patients with pathological or radiographical confirmed GIST liver metastases who underwent PET/CT (n=29), MRI (n=22), or both methods (n=4). PET/ CT and MRI interpretation including lesion's morphologic features, number, density or signal intensity, hemorrhage, cystic changes or necrosis, maximum standardized uptake value (SUV max ) of liver metastases and liver background on PET imaging, degree and pattern of enhancement on MRI were obtained by two experienced nuclear medicine physicians and two radiologists respectively. Data are presented as numbers, percentages, means ± standard deviations or median (interquartile range). The correlation between diameter and SUV max of metastases, and primary tumor SUV max and synchronous liver metastases SUV max were analyzed by Spearman's rank test.Results: On PET/CT visual analysis, 38.9%, 23.9%, and 37.2% of lesions showed significant hypermetabolism, slightly higher metabolism, and equal or lower metabolism than liver, respectively. There was a weak correlation between the diameter and SUV max of liver metastases (r s =0.370, P<0.001), and a moderate correlation between SUV max of synchronous liver metastases and the primary tumors (r s =0.492, P<0.001). On contrast-enhanced MRI, 90.8% of lesions showed heterogeneous enhancement in the arterial phase with the variable presentation, and 74.3% had different enhancement patterns between margins and intratumoral parenchyma.Conclusions: Liver lesions in GIST displaying significant, slight hypermetabolism on 18 F-FDG PET/ CT, marked or heterogeneous gradual enhancement within the intratumoral parenchyma with ring-like ^ ORCID: 0000-0003-2770-8909. enhancement on MRI may denote the diagnosis of liver metastasis. However, GIST liver metastases may also display equal or lower metabolism than liver parenchyma on PET, making small lesions more difficult to diagnose.

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Value of 18F-FDG PET/CT for differentiating diagnosis between malignant and benign primary gastric gastrointestinal mesenchymal tumors: a single-center retrospective study

Cited by 4 publications

References 26 publications

FDG PET/CT in Pancreatic Ductal Adenocarcinoma Arising From a Heterotopic Pancreas of the Pylorus

FDG PET/CT in Pancreatic Ductal Adenocarcinoma Arising From a Heterotopic Pancreas of the Pylorus

Clinical significance of 18F-FDG PET/CT imaging in 32 cases of gastrointestinal stromal tumors

18F-FDG PET/CT and MR imaging features of liver metastases in gastrointestinal stromal tumors: a cross-sectional analysis

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