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Comparison of CT and 18F-FDG PET for Detecting Peritoneal Metastasis on the Preoperative Evaluation for Gastric Carcinoma

 Joon Seok Lim  ;  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 
 KOREAN JOURNAL OF RADIOLOGY, Vol.7(4) : 249-256, 2006 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Contrast Media ; Female ; Fluorodeoxyglucose F18 ; Humans ; Iohexol/analogs & derivatives ; Male ; Middle Aged ; Peritoneal Neoplasms/diagnostic imaging* ; Peritoneal Neoplasms/secondary* ; Positron-Emission Tomography* ; ROC Curve ; Radiography ; Radiopharmaceuticals ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms/pathology* ; Tomography, Emission-Computed*
Stomach, neoplasms ; Peritoneum ; neoplasms ; Computed tomography (CT) ; Positron emission ; tomography
OBJECTIVE: The aim of our study was to compare the accuracy of CT and (18)FFDG 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 (18)F-FDG PET scanning for their preoperative evaluation. The sensitivities, specificities and accuracies of CT and (18)FFDG 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 (18)F-FDG PET imaging for detecting peritoneal metastasis.
RESULTS: Based on the original preoperative reports, CT and (18)F-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 (kappa value = 0.684) for CT and moderate (kappa 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.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Oh, Young Taik(오영택) ORCID logo https://orcid.org/0000-0002-4438-8890
Yoo, Hyung Sik(유형식)
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Jong Doo(이종두)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
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