Comparison of CT and 18F-FDG PET for Detecting Peritoneal Metastasis on the Preoperative Evaluation for Gastric Carcinoma.
- Author:
Joon Seok LIM
1
;
Myeong Jin KIM
;
Mi jin YUN
;
Young Taik OH
;
Joo Hee KIM
;
Hee Sung HWANG
;
Mi Suk PARK
;
Seoung Whan CHA
;
Jong Doo LEE
;
Sung Hoon NOH
;
Hyung Sik YOO
;
Ki Whang KIM
Author Information
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords: Stomach, neoplasms; Peritoneum, neoplasms; Computed tomography (CT); Positron emission tomography (PET)
- MeSH: *Tomography, Emission-Computed; Stomach Neoplasms/*pathology; Sensitivity and Specificity; Retrospective Studies; Radiopharmaceuticals/diagnostic use; ROC Curve; *Positron-Emission Tomography; Peritoneal Neoplasms/*radiography/*radionuclide imaging/*secondary; Middle Aged; Male; Iohexol/analogs & derivatives/diagnostic use; Humans; Fluorodeoxyglucose F18/diagnostic use; Female; Contrast Media; Aged, 80 and over; Aged; Adult; Adolescent
- From:Korean Journal of Radiology 2006;7(4):249-256
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The aim of our study was to compare the accuracy of CT and 18F-FDG PET for detecting peritoneal metastasis in patients with gastric carcinoma. MATERIALS AND METHODS: One-hundred-twelve patients who underwent a histologic confirmative exam or treatment (laparotomy, n = 107; diagnostic laparoscopy, n = 4; peritoneal washing cytology, n = 1) were retrospectively enrolled. All the patients underwent CT and 18F-FDG PET scanning for their preoperative evaluation. The sensitivities, specificities and accuracies of CT and 18F-FDG PET imaging for the detection of peritoneal metastasis were calculated and then compared using Fisher's exact probability test (p < 0.05), on the basis of the original preoperative reports. In addition, two board-certified radiologists and two board-certified nuclear medicine physicians independently reviewed the CT and PET scans, respectively. A receiver-operating characteristic curve analysis was performed to compare the diagnostic performance of CT and 18F-FDG PET imaging for detecting peritoneal metastasis. RESULTS: Based on the original preoperative reports, CT and 18F-FDG PET showed sensitivities of 76.5% and 35.3% (p = 0.037), specificities of 91.6% and 98.9% (p = 0.035), respectively, and equal accuracies of 89.3% (p = 1.0). The receptor operating characteristics curve analysis showed a significantly higher diagnostic performance for CT (Az = 0.878) than for PET (Az = 0.686) (p = 0.004). The interobserver agreement for detecting peritoneal metastasis was good (κ value = 0.684) for CT and moderate (κ value = 0.460) for PET. CONCLUSION: For the detection of peritoneal metastasis, CT was more sensitive and showed a higher diagnostic performance than PET, although CT had a relatively lower specificity than did PET.
