The value of FDG-PET in the staging of gastric adenocarcinoma: A single institution retrospective review.
BACKGROUND
The value of FDG-PET in the staging of gastric adenocarcinoma (GA) has been subject to debate.


METHODS
We performed a retrospective review of GA patients between 2006 and 2014 and identified those who had a CT and FDG-PET before initiating treatment. CT and FDG-PET images were analyzed by a blinded body radiologist and nuclear physician, respectively. Disease stage was assessed, looking at primary tumor (PT), locoregional (LLN) and distant lymph node disease (DLN), and metastasis (M).


RESULTS
We identified 608 patients who had biopsy-proven GA and 207 (34.0%) had a CT and FDG-PET as part of their staging work-up. Of these, imaging from 166 (27.3%) patients was available for review. CT identified PT, LLN, DLN, and M in 120 (72.3%), 84 (50.6%), 25 (15.1%), and 32 (19.3%) patients, respectively; while FDG-PET identified PT, LLN, DLN, and M in 125 (75.3%), 78 (47.0%), 41 (24.7%), and 27 (16.3%) of patients, respectively. FDG-PET up-staged 31 (18.7%) patients while it down-staged 17 (10.2%) patients. Of patients who were up-staged, 20 (64.5%) developed progressive disease.


CONCLUSIONS
Our findings support the use of FDG-PET as a valuable adjunct to CT in the staging of GA, as it changed the stage in 48 (28.9%) patients. J. Surg. Oncol. 2016;113:640-646. © 2016 Wiley Periodicals, Inc.
Department of Surgery, Montefiore Einstein Center for Cancer Care, Montefiore Medical Center, Bronx, New York.|Albert Einstein College of Medicine, New York City, New York.
Oscar K
OK
Serrano
Department of Nuclear Medicine, Montefiore Einstein Center for Cancer Care, Montefiore Medical Center, Bronx, New York.
Charito
C
Love
Department of Radiology, Montefiore Einstein Center for Cancer Care, Montefiore Medical Center, Bronx, New York.
Inessa
I
Goldman
Albert Einstein College of Medicine, New York City, New York.
Kevin
K
Huang
Albert Einstein College of Medicine, New York City, New York.
Nicole
N
Ng
Department of Nuclear Medicine, Montefiore Einstein Center for Cancer Care, Montefiore Medical Center, Bronx, New York.
Tony
T
Abraham
Department of Nuclear Medicine, Montefiore Einstein Center for Cancer Care, Montefiore Medical Center, Bronx, New York.
Raphaella
R
Da Silva
Albert Einstein College of Medicine, New York City, New York.
Patricia
P
Friedmann
Department of Surgery, Montefiore Einstein Center for Cancer Care, Montefiore Medical Center, Bronx, New York.|Albert Einstein College of Medicine, New York City, New York.
Steven K
SK
Libutti
Department of Surgery, Montefiore Einstein Center for Cancer Care, Montefiore Medical Center, Bronx, New York.|Albert Einstein College of Medicine, New York City, New York.
Timothy J
TJ
Kennedy
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D016037:Single-Blind Method; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
2-deoxy-2-[(18)F]fluoro-d-glucose; cancer; positron emission tomography; stomach