Effectiveness of Positron Emission Tomography in the Pre-operative Staging of Gastric Cancer.
10.5230/jkgca.2009.9.3.110
- Author:
Shin Young PARK
1
;
Jung Min BAE
;
Se Won KIM
;
Sang Woon KIM
;
Sun Kyo SONG
Author Information
1. Department of Surgery, College of Medicine, Yeungnam University, Daegu, Korea. sksong@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Gastric cancer;
Positron emission tomography-computed tomography
- MeSH:
Biopsy;
Electrons;
Humans;
Laparotomy;
Liver;
Lymph Nodes;
Neoplasm Metastasis;
Neoplasm Staging;
Positron-Emission Tomography;
Seeds;
Stomach Neoplasms
- From:Journal of the Korean Gastric Cancer Association
2009;9(3):110-116
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of this study was to examine the usefulness of positron emission tomography (PET)-computed tomography (CT) in the pre-operative staging of gastric cancer. MATERIALS AND METHODS: Between February 2006 and August 2008, PET-CT and CT were performed on 70 patients diagnosed with gastric cancer by gastrofiberscopic biopsy. The sensitivities, specificities, positive predictive value (PPV), and negative predictive value (NPV) of PET-CT and CT imaging for the detection of gastric cancer TNM staging were compared. RESULTS: The detection rates for the primary tumor were as follows: PET-CT, 81.4% (57/70); and CT, 42.9% (30/70). For both early gastric cancer (EGC) and advanced gastric cancer (AGC), PET-CT was more accurate than CT in detecting the lesions. As the size of the tumor exceeded 3 cm, the detection rate increased. The sensitivities, specificities, PPV, and NPV of PET-CT for lymph node staging were 55.6%, 81%, 86.2%, and 45.9%, while the sensitivities, specificities, PPV, and NPV of CT were 40.0%, 85.7%, 85.7% and 40%, respectively. One case of multiple liver metastasis and two cases of dual primary cancer (rectal and pancreatic cancers) were detected by PET-CT. PET-CT also had a higher detection rate for all histologic types of primary tumors. PET-CT was more accurate than CT in detecting primary gastric cancer lesions. The detection of nodal metastasis by PET-CT was similar to CT; small-sized tumors or EGC detection rates were not high. However, PET-CT provided additional information to detect distant metastases and dual primary cancers and reduced unnecessary laparotomies to detect peritoneal seeding or carcinomatosis. CONCLUSION: It would be useful to make a pre-operative diagnosis of gastric cancer and determine treatment if PET-CT were added to other routine pre-operative studies.
