Clinical value of whole-body FDG-PET for recurrent gastric cancer: a multicenter study.
OBJECTIVE
The purpose of this multicenter study was to evaluate the clinical usefulness of positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) for suspected recurrent gastric cancer.


METHODS
We performed a retrospective review of 92 consecutive patients who underwent PET [either integrated PET/computed tomography (CT) or manual fusion of dedicated PET and CT] scans for post-treatment surveillance of gastric cancer between June 2006 and December 2007. Of these patients, 46 patients were suspected of recurrence by other imaging modalities (Group A), 19 patients were suspected of recurrence by tumor markers without definite findings (Group B) and the remaining 27 patients underwent a PET scan without evidence of recurrence (Group C). The diagnostic performance and prevalence of the clinical impact of FDG-PET were analyzed.


RESULTS
Recurrence of gastric cancer was confirmed in 31 patients (67%) in Group A, in 11 patients (58%) in Group B and in 2 patients (7%) in Group C. In addition, colon cancer (n = 3), lung cancer (n = 1) and pulmonary carcinoid (n = 1) were identified in five patients (5%). In patient-basis, the sensitivity, specificity and diagnostic accuracy of PET for recurrence were 81%, 87% and 83%, respectively, in Group A, 73%, 88% and 79%, respectively, in Group B and 50%, 88% and 85%, respectively, in Group C. Therapeutic management was influenced by PET results in 22 patients (48%) in Group A, in 8 patients (42%) in Group B and in 2 patients (7%) in Group C, including cases in which PET was helpful for detecting second primary cancer.


CONCLUSIONS
PET with FDG yielded useful information in patients with suspected recurrent gastric cancer, especially when recurrence was suspected in the clinical setting.
Nakamoto
Yuji
Y
Department of Diagnostic Radiology, Kyoto University Hospital, Kyoto, Japan. ynakamo1@kuhp.kyoto-u.ac.jp
Togashi
Kaori
K
Kaneta
Tomohiro
T
Fukuda
Hiroshi
H
Nakajima
Kotaro
K
Kitajima
Kazuhiro
K
Murakami
Koji
K
Fujii
Hirofumi
H
Satake
Mitsuo
M
Tateishi
Ukihide
U
Kubota
Kazuo
K
Senda
Michio
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014915:Whole-Body Counting
D019788:Fluorodeoxyglucose F18