Evaluation of 18F-FDG uptake for detecting lymph node metastasis of gastric cancer: a prospective pilot study for one-to-one comparison of radiation dose and pathological findings.

Abstract

BACKGROUND:

Gastric cancer exhibits various degrees of fluorine F-18 fluorodeoxyglucose ((18)F-FDG) uptake on positron emission tomography/computed tomography (PET/CT). We evaluated the relationship between (18)F-FDG uptake and the presence/absence of metastasis in individual lymph nodes (LN) on a one-to-one basis.

METHODS:

We analyzed 21 patients with gastric cancer. We injected (18)F-FDG intravenously in the morning, and gastrectomy with LN dissection was performed in the afternoon of the same day. Radiation doses were measured at each LN using a well-type counter, and we then compared (18)F-FDG uptake, the shortest diameter, and pathological examination results for each LN.

RESULTS:

In our study, 906 LNs were analyzed, including 115 metastatic LNs. Metastatic LNs showed significantly higher (18)F-FDG uptake (P < 0.0001), and were significantly enlarged (P < 0.0001). The receiver operating characteristics (ROC) curve had a larger area under the curve (0.71) for (18)F-FDG uptake than for the shortest LN diameter (0.60). Considering histology, the ROC curve for intestinal type adenocarcinoma had a larger area under the curve than that for diffuse type (0.75 vs 0.61).

CONCLUSIONS:

F-FDG uptake is potentially a more useful variable than LN diameter for discriminating between LN with and without metastasis, especially in intestinal type gastric cancer cases.

• Authors: Yasuhiro Okumura, Susumu Aikou, Haruna Onoyama, Keiichi Jinbo, Yukinori Yamagata, Kazuhiko Mori, Hiroharu Yamashita, Sachiyo Nomura, Miwako Takahashi, Keitaro Koyama, Toshimitsu Momose, Hiroyuki Abe, Keisuke Matsusaka, Tetsuo Ushiku, Masashi Fukayama, Yasuyuki Seto
• Journal: World journal of surgical oncology (World J Surg Oncol) Vol. 13 Pg. 327 (Dec 02 2015) ISSN: 1477-7819 [Electronic] England
• PMID: 26628257 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adenocarcinoma (diagnosis, therapy)
• Adult
• Aged
• Aged, 80 and over
• Female
• Fluorodeoxyglucose F18
• Gastrectomy
• Humans
• Lymphatic Metastasis
• Male
• Middle Aged
• Multimodal Imaging
• Pilot Projects
• Positron-Emission Tomography
• Predictive Value of Tests
• Prospective Studies
• ROC Curve
• Radiation Dosage
• Radiopharmaceuticals
• Stomach Neoplasms (diagnosis, therapy)
• Tomography, X-Ray Computed