Abstract
Background
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.
Methods
Sixty-two gastric cancer patients who underwent FDG-PET imaging and gastric resection with lymphadenectomy were evaluated.
Results
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.
Conclusion
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.
Article PDF
Similar content being viewed by others
References
HW Yeung H Macapinlac M Karpeh RD Finn SM Larson (1998) ArticleTitleAccuracy of FDG-PET in gastric cancer. Preliminary experience Clin Positron Imaging 1 213–21 Occurrence Handle14516555 Occurrence Handle10.1016/S1095-0397(98)00018-1
A Stahl K Ott WA Weber K Becker T Link JR Siewert et al. (2003) ArticleTitleFDG PET imaging of locally advanced gastric carcinomas: correlation with endoscopic and histopathological findings Eur J Nucl Med 30 288–95 Occurrence Handle1:CAS:528:DC%2BD3sXms1Cmsw%3D%3D Occurrence Handle10.1007/s00259-002-1029-5
E Mochiki H Kuwano H Katoh T Asao N Oriuchi K Endo (2004) ArticleTitleEvaluation of 18F-2-deoxy-2-fluoro-d-glucose emission tomography for gastric cancer World J Surg 28 247–53 Occurrence Handle14961197 Occurrence Handle10.1007/s00268-003-7191-5
J Chen JH Cheong MJ Yun J Kim JS Lim WJ Hyung et al. (2005) ArticleTitleImprovement in preoperative staging of gastric adenocarcinoma with positron emission tomography Cancer 103 2383–90 Occurrence Handle15856477 Occurrence Handle10.1002/cncr.21074
H Koga M Sasaki Y Kuwabara K Hirata M Nakagawa K Abe et al. (2003) ArticleTitleAn analysis of the physiological FDG uptake pattern in the stomach Ann Nucl Med 17 733–8 Occurrence Handle14971621 Occurrence Handle1:CAS:528:DC%2BD2cXjtVahtbg%3D Occurrence Handle10.1007/BF02984984
InstitutionalAuthorNameJapanese Gastric Cancer Association (1998) ArticleTitleJapanese classification of gastric carcinoma: 2nd English edition Gastric Cancer 1 10–24 Occurrence Handle11957040 Occurrence Handle10.1007/PL00011681
SR Hamilton LA Aaltonen (2000) Tumors of the stomach S Hamilton L Aaltonen (Eds) WHO classification of tumors. Pathology and genetics, tumors of the digestive system IARC Lyon 38–52
MP Stokkel FW Broek GJ Hordijk R Koole PP van Rijk (2000) ArticleTitlePreoperative evaluation of patients with primary head and neck cancer using dual-head 18-fluorodeoxyglucose positron emission tomography Ann Surg 231 229–34 Occurrence Handle10674615 Occurrence Handle1:STN:280:DC%2BD3c7jslSrsg%3D%3D Occurrence Handle10.1097/00000658-200002000-00012
Pieterman RM, van Putten JW, Meuzelaar JJ, Mooyaart EL, Vaalburg W, Koëter GH, et al. Preoperative staging of non-small-cell lung cancer with positron-emission tomography. N Engl J Med 2000;254–61
P Flamen (2002) ArticleTitlePositron emission tomography in colorectal cancer Best Pract Res Clin Gastroenterol 16 237–51 Occurrence Handle11969236 Occurrence Handle10.1053/bega.2001.0283
P Flamen A Lerut E Van Cutsem W De Wever M Peeters S Stroobants et al. (2000) ArticleTitleUtility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma J Clin Oncol 18 3202–10 Occurrence Handle10986052 Occurrence Handle1:STN:280:DC%2BD3cvotlentw%3D%3D
T Kawamura T Kusakabe T Sugino K Watanabe T Fukuda A Nashimoto et al. (2001) ArticleTitleExpression of glucose transporter-1 in human gastric carcinoma Cancer 92 634–41 Occurrence Handle11505409 Occurrence Handle1:CAS:528:DC%2BD3MXmsVyjtLc%3D Occurrence Handle10.1002/1097-0142(20010801)92:3<634::AID-CNCR1364>3.0.CO;2-X
H Ohira K Kubota N Ohuchi Y Harada H Fukuda S Satomi (2000) ArticleTitleComparison of intratumoral distribution of 99mTc-MIBI and deoxyglucose in mouse breast cancer models J Nucl Med 41 1561–8 Occurrence Handle10994739 Occurrence Handle1:CAS:528:DC%2BD3cXntFOhtLs%3D
Kubota K, Ishiwata K, Kubota R, Yamada S, Tada M, Sato T, et al. Tracer feasibility of monitoring tumor radiotherapy: a quadruple tracer study with fluorine-18-fluorodeoxyglucose or fluorine-18-fluorodeoxyuridine, l-[methyl-14C]methionine, [6-3H] thymidine, and gallium-67. J Nucl Med 1991;2118–23
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mukai, K., Ishida, Y., Okajima, K. et al. Usefulness of preoperative FDG-PET for detection of gastric cancer. Gastric Cancer 9, 192–196 (2006). https://doi.org/10.1007/s10120-006-0374-7
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10120-006-0374-7