Advertisement

Whole-body PET with FDG for the diagnosis of recurrent gastric cancer

  • T. De Potter
  • P. Flamen
  • E. Van Cutsem
  • F. Penninckx
  • L. Filez
  • G. Bormans
  • A. Maes
  • L. Mortelmans
Original Article

Abstract.

This retrospective study was designed to assess the accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in diagnosing recurrence of gastric cancer. Thirty-three patients who had received surgical treatment for gastric cancer with curative intent and who had subsequently undergone FDG-PET for suspected recurrence were retrieved from the PET database. All patients were reviewed with full knowledge of prior conventional diagnostic work-up. Results were compared with a gold standard, consisting of histological confirmation or radiological and clinical follow-up. The gold standard established disease recurrence in 20/33 patients (prevalence 61%). Sensitivity and specificity of FDG-PET for the diagnosis of recurrence were 70% (14/20) and 69% (9/13), respectively. Positive and negative predictive values were 78% (14/18) and 60% (9/15), respectively. Of the six false-negative cases, all had intra-abdominal lesions (three had generalised abdominal metastases, one liver metastasis, one local recurrence and one ovarian metastasis). In the subgroup with previous signet cell differentiation of the primary tumour (n=13, disease prevalence 62%), sensitivity was 62% (5/8) and specificity, 60% (3/5). Survival analysis for the entire patient group using Kaplan-Meier statistics yielded a longer survival in the PET-negative group (mean±SD, 21.9±19.0 months) than in the PET-positive group (mean±SD, 9.2±8.2 months) (P=0.01). In the patient group with proven recurrence (n=20), the mean survival for the PET-negative group was 18.5 (±12.5) months, as compared with 6.9 (±6.5) months for the PET-positive group (P=0.05). Because of its poor sensitivity and low negative predictive value, FDG-PET is not suited for screening purposes in the follow-up of treated gastric cancer. However, FDG-PET appears to provide important additional information concerning the prognosis of recurrent gastric cancer.

FDG Positron emission tomography Recurrent gastric cancer Diagnosis Prognosis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • T. De Potter
    • 1
  • P. Flamen
    • 1
  • E. Van Cutsem
    • 2
  • F. Penninckx
    • 3
  • L. Filez
    • 3
  • G. Bormans
    • 1
  • A. Maes
    • 1
  • L. Mortelmans
    • 1
  1. 1.Department of Nuclear Medicine, University Hospital Leuven (KU Leuven), Herestraat 49, 3000 Leuven, BelgiumBelgium
  2. 2.Department of Internal Medicine, University Hospital Leuven (KU Leuven), BelgiumBelgium
  3. 3.Department of Abdominal Surgery, University Hospital Leuven (KU Leuven), BelgiumBelgium

Personalised recommendations