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Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography

 Jian Chen  ;  Jae-Ho Cheong  ;  Mi Jin Yun  ;  Junuk Kim  ;  Joon Seok Lim  ;  Woo Jin Hyung  ;  Sung Hoon Noh 
 CANCER, Vol.103(11) : 2383-2390, 2005 
Journal Title
Issue Date
Adenocarcinoma/diagnostic imaging* ; Adenocarcinoma/secondary ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Signet Ring Cell/diagnostic imaging ; Carcinoma, Signet Ring Cell/secondary ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymph Nodes/pathology ; Lymphatic Metastasis/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Peritoneal Neoplasms/diagnostic imaging ; Peritoneal Neoplasms/secondary ; Positron-Emission Tomography ; Preoperative Care ; Prognosis ; Radiography ; Radiopharmaceuticals ; Sensitivity and Specificity ; Stomach Neoplasms/diagnostic imaging* ; Stomach Neoplasms/surgery
gastric adenocarcinoma ; positron emission tomography ; computed tomography ; TNM staging
BACKGROUND: Positron emission tomography (PET) with 18- fluorodeoxyglucose (FDG) has been used to both detect and stage a variety of malignancies. The current study examined the value of PET for preoperative staging of gastric adenocarcinoma. METHODS: Sixty-eight patients (49 males and 19 females) with gastric adenocarcinoma, who were referred for preoperative FDG-PET scans, were enrolled in this study. The patients underwent spiral-computed tomography (CT) within 1 week of referral. The final diagnosis in all patients was made by histologic and surgical findings. For quantitative PET analysis, the regional tumor FDG uptake was measured by the standardized uptake value (SUV). RESULTS: For the primary tumor of a gastric adenocarcinoma, PET demonstrated an increased uptake in 64 of 68 patients (sensitivity, 94%), with a mean SUV of 7.0 (range, 0.9-27.7). A comparison of FDG uptake and clinicopathologic features showed significant association between FDG uptake and macroscopic type, tumor size, lymph node metastasis, histologic type, and TNM stage. The PET scan had a similar accuracy with that of CT for diagnosing local and distant lymph node metastases as well as peritoneal status. In assessing local lymph node status, however, PET had a higher specificity than CT (92% vs. 62%, P = 0.000). Moreover, PET had additional diagnostic value in 10 (15%) of 68 patients by upstaging 4 (6%) and downstaging 6 (9%) patients. PET combined with CT was more accurate for preoperative staging than either modality alone (66% vs. 51%, 66% vs. 47%, respectively; P = 0.002). CONCLUSIONS: FDG-PET improves the preoperative TNM staging of gastric adenocarcinoma. Based on its superior specificity, FDG-PET can facilitate the selection of patients for a curative resection by confirming a nodal status identified by CT.
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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, Junuk(김준억)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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