Is PET-CT suitable for predicting lymph node status for gastric cancer?
OBJECTIVE
To verify the value of PET-CT for predicting lymph node status of gastric cancer preoperatively.


METHODS
78 gastric cancer patients accepted PET-CT preoperatively, the results of lymph node status were compared with the postoperative pathology. CT was used as control.


RESULTS
The accuracy of PET-CT and CT in N category was 55.1% vs. 54.4%, respectively. The sensitivity, specificity, accuracy, positive predicting value (PPV), and negative predicting value (NPV) of PET-CT in predicting position of positive lymph node were 31.0%, 97.2%, 61.5%, 92.9%, and 54.7%, respectively. While for CT, were 60.5%, 83.3%, 70.6%, 82.1%, and 62.5%, respectively. For tier 1 lymph node metastasis, the sensitivity, specificity, accuracy, PPV, and NPV of PET-CT were 31.6%, 95.0%, 64.1%, 85.7%, and 59.4%, respectively. While for CT, were 60.0%, 78.8%, 69.1%, 75.0%, and 65.0%, respectively. The sensitivity of CT was significantly better (p = 0.031). For tier 2 or tier 3 lymph node metastasis, the sensitivity, specificity, accuracy, PPV, and NPV of PET-CT were 12.0%, 98.1%, 70.5%, 75.0%, and 70.3%, respectively. While for CT, were 22.7%, 93.5%, 70.6%, 62.5%, and 71.7%, respectively, without significance.


CONCLUSIONS
PET-CT is not sensitive enough to predict the regional lymph node status of gastric cancer preoperatively.
Yang
Qiu-Meng
QM
Department of Gastric Surgery, and Peritoneal Dissemination, Shizuoka Cancer Center, Japan.
Kawamura
Taiichi
T
Itoh
Hiroaki
H
Bando
Etsuro
E
Nemoto
Masayuki
M
Akamoto
Shintarou
S
Furukawa
Hiroyoshi
H
Yonemura
Yutaka
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed