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Evaluation of 18F-2-deoxy-2-fluoro-d-glucose Positron Emission Tomography for Gastric Cancer

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Abstract

Positron emission tomography (PET) with 18F-2-deoxy-2-fluoro-d-glucose (FDG) has been investigated as a means of detecting certain primary tumors and their metastatic disease in recent years. The aim of this study was to compare the performance of FDG-PET and operative assessment with formal pathologic staging. Altogether, 85 patients had undergone surgical treatment for gastric cancer with curative intent, with FDG-PET preoperatively. The results using FDG-PET were compared with those using computed tomography (CT); they were also correlated with the pathologic findings. For quantitative analysis, the regional tumor uptake was measured by the standard uptake value (SUV) using a region of interest technique. Using FDG-PET, the primary tumor was visualized in 75.2% of patients. A comparison of the FDG uptake and the clinicopathologic findings showed that there was a significant association between FDG uptake and the depth of invasion, the size of the tumor, and lymph node metastasis. FDG-PET scans had less accuracy for diagnosing locoregional lymph nodes than CT because of a significant lack of sensitivity (23.3% vs. 65.0%). The survival rate for patients with high FDG uptake (SUV > 4) was significantly lower than that for those with low FDG uptake (SUV < 4) (p < 0.05). FDG-PET was successful in detecting the primary gastric cancer lesion but not for finding early-stage gastric cancers. Detection of nodal metastasis also was not possible by FDG-PET. However, FDG-PET appears to provide important additional information concerning the aggressiveness of the tumor and the prognosis in patients with gastric cancer.

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Acknowledgments.

Financial support was provided by grant 13671280 from the Ministry of Education, Science and Culture of Japan.

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Authors and Affiliations

  1. Department of Surgery 1, Faculty of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi, 371-8511, Gunma, Japan

    Erito Mochiki M.D., Hiroyuki Kuwano M.D., Hiroyuki Katoh M.D. & Takayuki Asao M.D.

  2. Department of Nuclear Medicine, Faculty of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi, 371-8511, Gunma, Japan

    Noboru Oriuchi M.D. & Keigo Endo M.D.

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  1. Erito Mochiki M.D.
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  2. Hiroyuki Kuwano M.D.
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  3. Hiroyuki Katoh M.D.
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  4. Takayuki Asao M.D.
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  6. Keigo Endo M.D.
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Correspondence to Erito Mochiki M.D..

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Mochiki, E., Kuwano, H., Katoh, H. et al. Evaluation of 18F-2-deoxy-2-fluoro-d-glucose Positron Emission Tomography for Gastric Cancer. World J. Surg. 28, 247–253 (2004). https://doi.org/10.1007/s00268-003-7191-5

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