Added value of pretreatment ¹⁸F-FDG PET/CT for staging of advanced gastric cancer: Comparison with contrast-enhanced MDCT

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• 作者：Yusuke Kawanaka^a ; ¹ ; ^{n_you_634@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Kazuhiro Kitajima^a ; ¹ ; ^{kazu10041976@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Kazuhito Fukushima^a ; ¹ ; ^{fukuchan0106@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Miya Mouri^a ; ¹ ; ^{m-mou@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Hiroshi Doi^b ; ^{h-doi@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Tsutomu Oshima^c ; ^{tsutomu@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Hirotaka Niwa^c ; ^{hironiwa@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Nobuaki Kaibe^c ; ^{kaibe-2s@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Mitsuru Sasako^c ; ^{msasako@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Toshihiko Tomita^d ; ^{tomita@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Hiroto Miwa^d ; ^{miwahgi@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Shozo Hirota^b ; ^{hirota-s@hyo-med.ac.jp" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Gastric cancer ; Staging ; FDG ; PET/CT
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：85
• 期：5
• 页码：989-995
• 全文大小：1234 K

文摘

To evaluate the added clinical value of pretreatment ¹⁸F-FDG PET/CT compared with conventional contrast-enhanced multidetector-row CT (CECT) alone for staging of advanced gastric cancer

Materials and methods

We studied 106 patients with locally advanced gastric cancer who underwent pretreatment CECT and ¹⁸F-FDG PET/CT. Two experienced reviewers assessed the diagnostic performance of both CECT alone and the combination of CECT and ¹⁸F-FDG PET/CT for the primary tumor, regional lymph node metastasis (N) and distant metastasis (M), rating their diagnostic confidence with a 5-point scoring system for each location. The two methods were compared using receiver operating characteristic (ROC) curve analysis for histopathologic findings, imaging, and clinical follow-up as the reference standards.

Results

Among the 106 patients, 96 primary tumors (90.6%) were detected by CECT, while 101 (95.3%) were clearly identified by ¹⁸F-FDG PET/CT (p = 0.074). Patient-based areas under the ROC curves for CECT alone versus the combination of CECT and ¹⁸F-FDG PET/CT for diagnosis of N stage, peritoneal dissemination, liver metastasis, distant lymph node metastasis, bone metastasis, metastasis at other sites and overall M stage were 0.787 vs. 0.858 (p = 0.13), 0.866 vs. 0.878 (p = 0.31), 0.998 vs. 1.0 (p = 0.36), 0.744 vs. 0.865 (p = 0.049), 0.786 vs. 0.998 (p = 0.034), 0.944 vs. 0.984 (p = 0.34), and 0.889 vs. 0.912 (p = 0.21), respectively. The diagnostic performance of primary tumor detection and NM staging was not influenced by the histologic subtype.

Conclusion

Adding ¹⁸F-FDG PET/CT to CECT provides better diagnostic accuracy for detection of distant lymph node metastasis and bone metastasis in patients with untreated advanced gastric cancer.