Comparison between endoscopic macroscopic classification and F-18 FDG PET findings in gastric mucosa-associated lymphoid tissue lymphoma patients.
OBJECTIVE
The aim of this study was to compare endoscopic macroscopic classification with fluorine-18 fluorodeoxyglucose (F-18 FDG) uptake in gastric mucosa-associated lymphoid tissue (MALT) lymphoma and to investigate the usefulness of F-18 FDG positron emission tomography (PET) for diagnosing gastric MALT lymphoma.


METHODS
Sixteen patients with gastric MALT lymphoma who underwent F-18 FDG PET and gastrointestinal imaging modalities were included in this study. Sixteen healthy asymptomatic participants undergoing both F-18 FDG PET and endoscopy for cancer screening were in the control group. We investigated the difference of F-18 FDG uptake between the gastric MALT lymphoma and the control group and compared the uptake pattern in gastric MALT lymphoma with our macroscopic classification.


RESULTS
The endoscopic findings of 16 gastric MALT lymphoma patients were classified macroscopically as chronic gastritis-like tumors (n = 6), depressed tumors (n = 5), and protruding tumors (n = 5). Abnormal gastric F-18 FDG uptake was observed in 63% of tumors in the gastric MALT lymphoma group and 50% of cases in the control group. The median maximum standardized uptake values for gastric MALT lymphoma patients and control group were 4.0 and 2.6, respectively, the difference of which was statistically significant (P = 0.003). F-18 FDG uptake results were positive for all protruding tumors but only 50% for chronic gastritis-like tumors and 40% for depressed-type tumors.


CONCLUSIONS
F-18 FDG PET may be a useful method for evaluating protrusion-type gastric MALT lymphoma. When strong focal or diffuse F-18 FDG uptake is detected in the stomach, endoscopic biopsy should be performed, even if the endoscopic finding is chronic gastritis.
Division of Nuclear Medicine, PET Center and Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan. shinnichiizm@piano.ocn.ne.jp
Yasumitsu
Y
Hirose
Hayato
H
Kaida
Masatoshi
M
Ishibashi
Jun
J
Uozumi
Shunji
S
Arikawa
Seiji
S
Kurata
Naofumi
N
Hayabuchi
Keita
K
Nakahara
Koichi
K
Ohshima
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004724:Endoscopy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005753:Gastric Mucosa / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000145:classification* / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D055815:Young Adult
D019788:Fluorodeoxyglucose F18