title: Evaluation of 18F-FDG uptake for detecting lymph node metastasis of gastric cancer: a prospective pilot study for one-to-one comparison of radiation dose and pathological findings.
abstract: BACKGROUND
  Gastric cancer exhibits various degrees of fluorine F-18 fluorodeoxyglucose ((18)F-FDG) uptake on positron emission tomography/computed tomography (PET/CT). We evaluated the relationship between (18)F-FDG uptake and the presence/absence of metastasis in individual lymph nodes (LN) on a one-to-one basis.
  
  
  METHODS
  We analyzed 21 patients with gastric cancer. We injected (18)F-FDG intravenously in the morning, and gastrectomy with LN dissection was performed in the afternoon of the same day. Radiation doses were measured at each LN using a well-type counter, and we then compared (18)F-FDG uptake, the shortest diameter, and pathological examination results for each LN.
  
  
  RESULTS
  In our study, 906 LNs were analyzed, including 115 metastatic LNs. Metastatic LNs showed significantly higher (18)F-FDG uptake (P < 0.0001), and were significantly enlarged (P < 0.0001). The receiver operating characteristics (ROC) curve had a larger area under the curve (0.71) for (18)F-FDG uptake than for the shortest LN diameter (0.60). Considering histology, the ROC curve for intestinal type adenocarcinoma had a larger area under the curve than that for diffuse type (0.75 vs 0.61).
  
  
  CONCLUSIONS
  F-FDG uptake is potentially a more useful variable than LN diameter for discriminating between LN with and without metastasis, especially in intestinal type gastric cancer cases.
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. okumura-tky@umin.ac.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okumura
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. aikous-tky@umin.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Aikou
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. onoyamah-sur@h.u-tokyo.ac.jp.
authors.forename: Haruna
authors.initials: H
authors.lastname: Onoyama
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. jinbok-sur@h.u-tokyo.ac.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Jinbo
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. yamagay-tky@umin.ac.jp.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Yamagata
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. morikaz158@gmail.com.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. hyamashi@umin.net.
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. nomuras-dis@h.u-tokyo.ac.jp.
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Nomura
authors.affiliation: Department of Nuclear Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. takahashim-rad@h.u-tokyo.ac.jp.
authors.forename: Miwako
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Nuclear Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. koyamak-rad@h.u-tokyo.ac.jp.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Koyama
authors.affiliation: Department of Nuclear Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. momose-rad@h.u-tokyo.ac.jp.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Momose
authors.affiliation: Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. abeh-pat@h.u-tokyo.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. ksk.matsusaka@gmail.com.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Matsusaka
authors.affiliation: Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. ushikut-pat@h.u-tokyo.ac.jp.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ushiku
authors.affiliation: Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. fukayamam-pat@h.u-tokyo.ac.jp.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukayama
authors.affiliation: Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. seto-tky@umin.ac.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Seto
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D011829:Radiation Dosage; D019275:Radiopharmaceuticals; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18