Skip to main content
SpringerLink
Log in

18F-Fluorodeoxyglucose Positron Emission Tomography: Useful Technique for Predicting Malignant Potential of Gastrointestinal Stromal Tumors

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

The malignant potential of gastrointestinal stromal tumors (GISTs) is difficult to diagnose before surgery because the diagnoses are based on tumor diameter and mitotic index. The progression of small GISTs is always observed because they do not seem to have malignant potential. 18F-Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is a useful technique for assessing tumor activity. The objective of this study was to determine if FDG-PET is useful for predicting the malignant potential of gastric GISTs. Ten patients diagnosed with gastric GISTs participated. FDG-PET was performed on all of them before tumor resection. A whole-body image was initiated 40 minutes after the injection of 275 to 370 MBq FDG. FDG uptake was assessed by a standardized uptake value. All tumors had FDG uptake. There was a significant correlation between the FDG uptake and both the Ki67 index and the mitotic index but not the tumor diameter. The FDG uptake and malignant potential of gastric GISTs had a significant correlation. FDG-PET may be of considerable value for predicting the malignant potential of gastric GISTs before surgery. A gastric GIST with a high FDG uptake should be regarded as having malignant potential.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Miettinen M. Gastrointestinal stromal tumors: an immunohistochemical study of cellular differentiation. Am J Clin Pathol 1988;89:601–610

    PubMed  CAS  Google Scholar 

  2. Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutation of c-kit in human gastrointestinal stromal tumors. Science 1998;279:577–580

    Article  PubMed  CAS  Google Scholar 

  3. Kindblom LG, Remotti HE, Aldenborg F, et al. Gastrointestinal pacemaker cell tumor (GI-PACT): gastrointestinal stromal tumors show phenotypic characteristics of the intestinal cells of Cajal. Am J Pathol 1998;152:1259–1269

    PubMed  CAS  Google Scholar 

  4. DeMatteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg 2000;231:51–58

    Article  PubMed  CAS  Google Scholar 

  5. Miettinen M, Lasota J. Gastrointestinal stromal tumors: definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch 2001;438:1–12

    Article  PubMed  CAS  Google Scholar 

  6. DeMatteo RP, Heinrich MC, El-Rifai WM, et al. Clinical management of gastrointestinal stromal tumors: before and after STI-571. Hum Pathol 2002;5:466–477

    Google Scholar 

  7. Demetri GD, von Mehren M, Blanke CD, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 2002;347:472–80

    Article  PubMed  CAS  Google Scholar 

  8. Miettinen M, El-Rifai W, Sobin LH, et al. Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Hum Pathol 2002;35:478–483

    Google Scholar 

  9. Valk PE, Pounds TR, Hopkins DM, et al. Staging non-small cell lung cancer by whole-body positron emission tomographic imaging. Ann Thorac Surg 1995;60:1573–1581

    Article  PubMed  CAS  Google Scholar 

  10. Vitola JV, Delbeke D, Sandler MP, et al. Positron emission tomography to stage suspected metastatic colorectal carcinoma to the liver. Am J Surg 1996;171:21–26

    Article  PubMed  CAS  Google Scholar 

  11. Kole AC, Plukker JT, Nieweg OE, et al. Positron emission tomography for staging oesophageal and gastroesophageal malignancy. Br J Cancer 1998;78:521–527

    PubMed  CAS  Google Scholar 

  12. Bar-Shalom R, Valdivia AY, Blaufox MD. PET imaging in oncology. Semin Nucl Med 2000;30:150–185

    PubMed  CAS  Google Scholar 

  13. Kato H, Kuwano H, Nakajima M, et al. Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma. Cancer 2002;94:921–928

    PubMed  Google Scholar 

  14. Mochiki E, Kuwano H, Katoh H, et al. Evaluation of 18F-2-deoxy-d-glucose positron emission tomography for gastric cancer. World J Surg 2004;28:247–253

    Article  PubMed  Google Scholar 

  15. Van den Abbeele AD, Badawi RD. Use of positron emission tomography in oncology and its potential role to assess response to imatinib mesylate therapy in gastrointestinal stromal tumors (GISTs). Eur J Cancer 2002;38(Suppl. 5):S60–S65

    PubMed  Google Scholar 

  16. Inoue T, Oriuchi N, Kunio M, et al. Accuracy of standardized uptake value measured by simultaneous emission and transmission scanning in PET oncology. Nucl Med Commun 1999;20:849–857

    PubMed  CAS  Google Scholar 

  17. Zasadny KR, Wahl RL. Standardized uptake values of normal tissues at PET with 2-(fluorine-18)-fluoro-2-deoxy-d-glucose: variations with body weight and a method for correction. Radiology 1993;189:847–850

    PubMed  CAS  Google Scholar 

  18. Koga H, Sasaki M, Kuwabara Y, et al. An analysis of the physiological FDG uptake pattern in the stomach. Ann Nucl Med 2003;17:733–738

    Article  PubMed  CAS  Google Scholar 

  19. Jerusalem G, Hustinx R, Beguin Y, et al. PET scan imaging in oncology. Eur J Cancer 2003;39:1525–1534

    Article  PubMed  CAS  Google Scholar 

  20. Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology. Hum Pathol 1999;30:1213–1220

    PubMed  CAS  Google Scholar 

  21. Wang X, Mori I, Tang W, et al. Helpful parameter for malignant potential of gastrointestinal stromal tumors (GIST). Jpn J Clin Oncol 2002;32:347–351

    Article  PubMed  Google Scholar 

  22. Seidal T, Edvardsson H. Expression of c-kit (CD117) and Ki67 provides information about the possible cell of origin and clinical course of gastrointestinal stromal tumors. Histopathology 1999;34:416–424

    Article  PubMed  CAS  Google Scholar 

  23. Wong NA, Young R, Malcomson RD, et al. Prognostic indicators for gastrointestinal stromal tumors: a clinicopathological and immunohistochemical study of 108 resected cases of the stomach. Histopathology 2003;43:118–126

    Article  PubMed  CAS  Google Scholar 

  24. Hasegawa T, Matsuno Y, Shimoda T, et al. Gastrointestinal stromal tumor: consistent CD117 immunostaining for diagnosis, and prognostic classification based on tumor size and MIB-1 grade. Hum Pathol 2002;33:669–676

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Yoichi Kamiyama MD, Ryuusuke Aihara MD, PhD, Toshihiro Nakabayashi MD, PhD, Erito Mochiki MD, PhD, Takayuki Asao MD, PhD & Hiroyuki Kuwano MD, PhD

  2. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University, Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Nobuo Oriuchi MD, PhD & Keigo Endo MD, PhD

Authors
  1. Yoichi Kamiyama MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryuusuke Aihara MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toshihiro Nakabayashi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Erito Mochiki MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takayuki Asao MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroyuki Kuwano MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nobuo Oriuchi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Keigo Endo MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoichi Kamiyama MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kamiyama, Y., Aihara, R., Nakabayashi, T. et al. 18F-Fluorodeoxyglucose Positron Emission Tomography: Useful Technique for Predicting Malignant Potential of Gastrointestinal Stromal Tumors. World J. Surg. 29, 1429–1435 (2005). https://doi.org/10.1007/s00268-005-0045-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-005-0045-6

Keywords

Search

Navigation