Gastric Cancer

, Volume 9, Issue 3, pp 192–196

Usefulness of preoperative FDG-PET for detection of gastric cancer


  • Kota Mukai
    • Department of SurgeryHimeji Central Hospital
  • Yasuhiko Ishida
    • Department of SurgeryHimeji Central Hospital
  • Kunio Okajima
    • Department of SurgeryHimeji Central Hospital
  • Hiroshi Isozaki
    • Department of SurgeryOomoto Hospital
  • Tsukasa Morimoto
    • Department of RadiologyHimeji Central Hospital
  • Shoji Nishiyama
    • Department of RadiologyHimeji Central Hospital
Original article

DOI: 10.1007/s10120-006-0374-7

Cite this article as:
Mukai, K., Ishida, Y., Okajima, K. et al. Gastric Cancer (2006) 9: 192. doi:10.1007/s10120-006-0374-7



Positron emission tomography (PET), using 18F-fluoro-2-deoxy-d-glucose (FDG) as a tracer, can detect malignant neoplasms with altered glucose metabolism. To clarify the usefulness of FDG-PET for detecting gastric cancer, we evaluated preoperative PET imaging in gastric cancer patients.


Sixty-two gastric cancer patients who underwent FDG-PET imaging and gastric resection with lymphadenectomy were evaluated.


For primary tumor assessment by PET, detection rates were significantly different in the following order: tumor size 30 mm or more (76.7%) > tumor size less than 30 mm (16.8%); advanced gastric cancer (AGC, 82.9%) > early gastric cancer (EGC; 25.9%); with nodal involvement (79.3%) > without nodal involvement (39.4%). In EGCs, the detection rate of the intestinal type, according to Lauren's classification (43.8%) was significantly higher than that of the diffuse type (0%). Two of the 7 EGC patients who were PET-positive had nodal involvement and their tumors were the intestinal type. For the assessment of nodal involvement, the accuracy of nodal involvement detection was 67.7% with PET and 75.8% with computed tomography (CT). Preoperative FDG-PET revealed colon cancer in 2 patients, adrenal tumor in 1 patient, lung cancer in 1 patient, and lung metastasis in 1 patient.


Larger or more advanced tumors with nodal involvement had a higher detection rate by PET. In EGCs, only the intestinal type was detectable by PET. PET-positive EGC may be aggressive, and an adequate lymphadenectomy must be done. Preoperative PET was useful for the detection of other malignancies and distant metastasis.

Key words

FDG-PETGastric cancerPreoperative diagnosisNodal involvementDistant metastasis
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© International and Japanese Gastric Cancer Association 2006