title: Significance of (18)F-2-deoxy-2-fluoro-glucose accumulation in the stomach on positron emission tomography.
abstract: OBJECTIVE
  To explain the accumulation of (18)F-2-deoxy-2-fluoro-glucose ((18)FDG) on positron emission tomography (PET) in the stomach and differences in its pattern, we focus on the accumulation pattern in association with endoscopic findings of the gastric mucosa and Helicobacter pylori (Hp) infection.
  
  
  METHODS
  Of 599 cases undergoing (18)FDG-PET examinations, we retrospectively analyzed the pattern of (18)FDG accumulation in the stomach, findings of upper gastrointestinal endoscopy, and Hp infection. The pattern of (18)FDG accumulation was classified into three groups: localized accumulation only in the fornix (Group A, 32 patients), diffuse accumulation throughout the entire stomach (Group B, 49 patients), and no accumulation (Group C, 191 patients).
  
  
  RESULTS
  Regarding the relation between Hp infection and (18)FDG accumulation, Hp infection was positive in 56.3% of Group A, 73.5% of Group B, and 24.1% of Group C, with significant differences (p < 0.001). Regarding the relation between (18)FDG accumulation and gastric mucosal inflammation, when Groups A and B were compared with Group C, nearly half of the cases in the former groups had papular redness with a significantly higher frequency of redness and erosion. Three cases found to have malignant tumor were limited to the former groups. One MALT lymphoma case was also found in the same group. Accumulation of (18)FDG largely corresponded to mucosal inflammation including superficial gastritis and erosive gastritis, and therefore the main cause of non-specific (18)FDG accumulation was considered to be inflammatory mucosa (mainly redness). The accumulation pattern was not associated with atrophic changes of the gastric mucosa or with Hp infection, but with mucosal inflammatory changes, including redness and erosion localized to the fornix.
  
  
  CONCLUSIONS
  Accumulation of (18)FDG in the stomach suggests a high probability of the presence of inflammatory change in the gastric mucosa forming a background for the development of cancer or malignant lymphoma, and thus requires further endoscopic examinations.
authors.affiliation: Department of Cancer Screening Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan. hiroshi.takahashi@jfcr.or.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Kunio
authors.initials: K
authors.lastname: Ukawa
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Ohkawa
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kato
authors.forename: Yuuko
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Yoshimoto
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ishiyama
authors.forename: Nobuko
authors.initials: N
authors.lastname: Ueki
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kuraoka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tsuchida
authors.forename: Yorimasa
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Akiko
authors.initials: A
authors.lastname: Chino
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Uragami
authors.forename: Junko
authors.initials: J
authors.lastname: Fujisaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Igarashi
authors.forename: Rikiya
authors.initials: R
authors.lastname: Fujita
authors.forename: Masamichi
authors.initials: M
authors.lastname: Koyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D016099:Endoscopy, Gastrointestinal; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism / Q000493:pharmacokinetics*; D005753:Gastric Mucosa / Q000000981:diagnostic imaging / Q000378:metabolism*; D005757:Gastritis, Atrophic / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016481:Helicobacter Infections / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016480:Helicobacter pylori; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D013270:Stomach / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery
chemical_list: D019788:Fluorodeoxyglucose F18