The value of vesicant 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in gastric malignancies.
OBJECTIVE
The value of vesicant 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in the detection and staging of primary gastric malignancies was studied prospectively.


METHODS
Thirty-eight patients with suspected gastric tumour were imaged with three-dimensional PET after the injection of 18F-FDG. During the PET study, vesicant was given orally in order to extend the stomach with CO(2) gas. Surgical operation (n=31) or gastric endoscopy with biopsy (n=7) was undertaken 3-26 days after the PET study. The PET results were compared with clinical (computed tomography/magnetic resonance imaging/ultrasound), surgical and histological staging.


RESULTS
PET correctly diagnosed 83.3% of primary malignant (25/30) and benign (7/8) lesions, and corrected 11 clinically and five surgically mis-staged cases. Five primaries were false-negatives in quantitative analysis, but qualitative PET readings revealed positive lymph nodes, thereby providing a correct diagnosis in two of the five. PET misdiagnosed seven N1, one N2 and one false-positive case. The focal uptake of 18F-FDG was correlated with the differentiation, size and depth of invasion of the gastric tumours.


CONCLUSIONS
18F-FDG PET is useful for the detection and staging of primary gastric malignancies, and the administration of vesicant may improve the diagnostic confidence.
Tian
Jiahe
J
Department of Nuclear Medicine, The Chinese PLA General Hospital, Beijing, China. tianjh@vip.spina.com.cn
Chen
Lin
L
Wei
Bo
B
Shao
Mingzhe
M
Ding
Yong
Y
Yin
Dayi
D
Yao
Shulin
S
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007509:Irritants; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
D007509:Irritants; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18