Improving evaluation of primary gastric malignancies by distending the stomach with milk immediately before 18F-FDG PET scanning.
This study was designed to investigate the feasibility and effectiveness of a modified protocol for (18)F-FDG PET that was proposed to improve the identification of primary gastric malignancies.


METHODS
In the modified protocol, patients were asked to drink 300-500 mL of cow milk to distend the stomach immediately before PET scans instead of fasting all along. For investigation of the influence of ingested milk on (18)F-FDG distributions, 43 nondiabetic patients without documented gastric diseases underwent both empty- and distended-stomach PET scans (79 and 72 scans, respectively) in their serial follow-up studies. For the evaluation of proven gastric malignancies, 24 patients who underwent distended-stomach PET scans were compared with 17 patients who underwent conventional empty-stomach examinations.


RESULTS
Ingestion of milk nearly 1 h after (18)F-FDG injection had no significant influence on distributions to the heart (P = 0.16), mediastinum (P = 0.50), and liver (P = 0.49), whereas the percentages of intense and moderate uptake in the stomach changed from 38.0% and 59.5% to 0% and 11.1%, respectively. With the normal gastric wall distended, malignant lesions were observed with higher contrast and clearer outlines, and some of them were detected at a small size (1.2 cm) at an early stage and with mild uptake.


CONCLUSIONS
Gastric distention with milk just before (18)F-FDG PET is a simple and effective method for improving the evaluation of primary gastric malignancies.
Zhu
Zhaohui
Z
Department of Nuclear Medicine, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, China. zzh_1969@yahoo.com
Li
Fang
F
Mao
Yilei
Y
Cheng
Wuying
W
Cheng
Xin
X
Dang
Yonghong
Y
D000818:Animals; D002417:Cattle; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D008892:Milk; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013270:Stomach / Q000000981:diagnostic imaging*; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18