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Annals of Nuclear Medicine

, Volume 30, Issue 4, pp 279–286 | Cite as

Prognostic value of 18F-fluorodeoxyglucose positron emission tomography in patients with gastric neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma

  • Sun Min Lim
  • Hyunki Kim
  • Beodeul Kang
  • Hyo Song Kim
  • Sun Young Rha
  • Sung Hoon Noh
  • Woo Jin Hyung
  • Jae-Ho Cheong
  • Hyoung-Il Kim
  • Hyun Cheol Chung
  • Mijin Yun
  • Arthur ChoEmail author
  • Minkyu JungEmail author
Original Article

Abstract

Objective

Gastric neuroendocrine carcinomas (NEC) and mixed adenoneuroendocrine carcinoma (MANEC) are very rare, aggressive tumors of the stomach. We aimed to examine predictive role of pretreatment 18F-FDG PET/CT-assessed metabolic parameter of primary tumors and metastases in patients with gastric NEC and MANEC.

Methods

We conducted a review of the 27 patients with histopathologically confirmed NECs (n = 10) and MANEC (n = 17) of the stomach at our institution between January 2005 and December 2012. All patients underwent 18F-FDG-PET examination at diagnosis. Metabolic parameters [SUVmax, SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG)] of the primary tumor and metastases on baseline PET/CT were analyzed.

Results

The median follow-up duration was 39.4 months (95 % CI 20.0–58.1 months) and the median overall survival (OS) was 25.7 months (95 % CI 14.1–37.2 months). All gastric lesions were well visualized (average SUVmax = 12.0, range 3.0–41.8). When subjects were divided into two groups by ROC cut-off value of 210.9 and 612, patients with high TLG in primary lesion and metastases showed poorer prognosis compared to low TLG patients (P = 0.09, P = 0.002, respectively). In the sub-analysis of patients with metastasis (n = 12), patients with high TLG in whole body tumor showed significantly shorter OS compared to those with low TLG (31.7 ± 11.4 vs. 7.2 ± 2.1 months, P = 0.006).

Conclusion

18F-FDG PET/CT is useful in evaluating prognosis of advanced gastric cancer with neuroendocrine carcinoma components. Baseline MTV of primary gastric cancer with metastatic disease, and MTV, TLG of metastases may be prognostic markers in patients with gastric NEC and MANEC.

Keywords

18F-FDG PET/CT Survival Gastric Neuroendocrine carcinoma Mixed adenoneuroendocine carcinoma 

Notes

Acknowledgments

This study was supported by a new faculty research seed money Grant of Yonsei University College of Medicine for 2014 (2014-32-0028).

Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

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Copyright information

© The Japanese Society of Nuclear Medicine 2016

Authors and Affiliations

  • Sun Min Lim
    • 1
    • 2
  • Hyunki Kim
    • 3
  • Beodeul Kang
    • 4
  • Hyo Song Kim
    • 1
  • Sun Young Rha
    • 1
  • Sung Hoon Noh
    • 5
  • Woo Jin Hyung
    • 5
  • Jae-Ho Cheong
    • 5
  • Hyoung-Il Kim
    • 5
  • Hyun Cheol Chung
    • 1
  • Mijin Yun
    • 6
  • Arthur Cho
    • 6
    Email author
  • Minkyu Jung
    • 1
    Email author
  1. 1.Division of Medical Oncology, Department of Internal MedicineYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Division of Medical Oncology, Department of Internal Medicine, CHA Bundang Medical CenterCHA UniversitySeongnamRepublic of Korea
  3. 3.Department of PathologyYonsei University College of MedicineSeoulRepublic of Korea
  4. 4.Division of Hematology and Medical Oncology, Department of Internal MedicineSeoul National University Bundang HospitalSeongnamRepublic of Korea
  5. 5.Department of SurgeryYonsei University College of MedicineSeoulRepublic of Korea
  6. 6.Department of Nuclear MedicineYonsei University College of MedicineSeoulRepublic of Korea

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