title: The predictive value of preoperative18F-fluorodeoxyglucose PET for postoperative recurrence in patients with localized primary gastrointestinal stromal tumour.
abstract: OBJECTIVE
  To assess the potential value of preoperative18F-FDG PET to predict postoperative recurrence of solitary localized primary gastrointestinal stromal tumour (GIST) after radical resection.
  
  
  METHODS
  A total of 46 patients with primary GIST who received preoperative18F-FDG PET and underwent complete resection without neoadjuvant therapy were retrospectively studied. PET findings, including ring-shaped uptake and intense uptake, were compared with Joensuu risk grades using Fisher's exact test. The prognostic value of the preoperative clinico-imaging variables-age ≥60 years, male, ring-shaped uptake, intense uptake, tumour size >5 cm, heterogeneous CT attenuation and lower gastrointestinal origin-and Joensuu high risk for recurrence-free survival was evaluated using log-rank test and multivariate Cox regression analysis.
  
  
  RESULTS
  Ring-shaped uptake and intense uptake were significantly associated with Joensuu high risk. Univariate analysis showed that ring-shaped uptake, intense uptake, size >5 cm and Joensuu high risk were significantly associated with inferior recurrence-free survival. Multivariate analysis showed that ring-shaped uptake (P = 0.004) and Joensuu high risk (P = 0.021) were independent adverse prognostic factors of postoperative recurrence.
  
  
  CONCLUSIONS
  Ring-shaped uptake on preoperative18F-FDG PET may be a potential predictor of postoperative tumour recurrence of localized primary GISTs.
  
  
  CONCLUSIONS
  • Clinical course of resectable solitary localized primary GISTs varies widely. • Ring-shaped uptake is an independent adverse prognostic factor of postoperative recurrence. • Preoperative18F-FDG PET may help predict postoperative recurrence of GISTs.
authors: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan. kanaek@kuhp.kyoto-u.ac.jp.
authors: Kanae Kawai
authors: KK
authors: Miyake
authors: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan.
authors: Yuji
authors: Y
authors: Nakamoto
authors: Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan.|Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan.
authors: Yoshiki
authors: Y
authors: Mikami
authors: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors: Shiro
authors: S
authors: Tanaka
authors: Shiga Medical Center Research Institute, Shiga, Japan.
authors: Tatsuya
authors: T
authors: Higashi
authors: Department of Radiology, Sakazaki Clinic, Kyoto, Japan.
authors: Eiji
authors: E
authors: Tadamura
authors: Dianostic Imaging Group, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan.
authors: Tsuneo
authors: T
authors: Saga
authors: Department of Radiology, Shiga Medical Center for Adults, Shiga, Japan.
authors: Shunsuke
authors: S
authors: Minami
authors: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan.
authors: Kaori
authors: K
authors: Togashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging* / Q000601:surgery; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET); Gastrointestinal stromal tumour (GIST); Postoperative recurrence; Recurrence-free survival; Ring-shaped uptake