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Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The present study evaluated the diagnostic performance of 2-[18F] fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for surveillance in asymptomatic gastric cancer patients after curative surgical resection.

Methods

We retrospectively recruited 190 gastric cancer patients (115 early gastric cancer patients and 75 advanced gastric cancer patients) who underwent 1-year (91 patients) or 2-year (99 patients) postoperative FDG PET/CT surveillance, along with a routine follow-up program, after curative surgical resection. All enrolled patients were asymptomatic and showed no recurrence on follow-up examinations performed before PET/CT surveillance. All PET/CT images were visually assessed and all abnormal findings on follow-up examinations including FDG PET/CT were confirmed with histopathological diagnosis or clinical follow-up.

Results

During follow-up, 19 patients (10.0 %) developed recurrence. FDG PET/CT showed abnormal findings in 37 patients (19.5 %). Among them, 16 patients (8.4 %) were diagnosed as cancer recurrence. Of 153 patients without abnormal findings on PET/CT, three patients were false-negative and diagnosed as recurrence on other follow-up examinations. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG PET/CT were 84.2 %, 87.7 %, 43.2 %, and 98.0 %, respectively. Among 115 early gastric cancer patients, PET/CT detected recurrence in four patients (3.5 %) and one patient with local recurrence. Among 75 advanced gastric cancer patients, PET/CT detected recurrence in 12 patients (16.0 %), excluding two patients experiencing peritoneal recurrence. In addition, FDG PET/CT detected secondary primary cancer in six (3.2 %) out of all the patients.

Conclusions

Post-operative FDG PET/CT surveillance showed good diagnostic ability for detecting recurrence in gastric cancer patients. FDG PET/CT could be a useful follow-up modality for gastric cancer patients, especially those with advanced gastric cancer. However, further careful evaluation is needed because of false-positive findings on PET/CT.

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Authors and Affiliations

  1. Department of Nuclear Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea

    Jeong Won Lee

  2. Department of Nuclear Medicine, Soonchunhyang University Hospital, 23-20 Byeongmyeong-dong, Dongnam-gu, Chungcheongnam-do, Cheonan, Korea, 330-721

    Sang Mi Lee

  3. Department of Surgery, Soonchunhyang University Hospital, Cheonan, Korea

    Myoung Won Son & Moon-Soo Lee

Authors
  1. Jeong Won Lee
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  2. Sang Mi Lee
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Correspondence to Sang Mi Lee.

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Funding

This work was supported in part by the Soonchunhyang University Research Fund.

Conflicts of interest

Jeong Won Lee declares that he has no conflict of interest.

Sang Mi Lee declares that she has no conflict of interest.

Myoung Won Son declares that he has no conflict of interest.

Moon-Soo Lee declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The institutional review board of our university approved this retrospective study, and the requirement to obtain informed consent was waived.

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Lee, J.W., Lee, S.M., Son, M.W. et al. Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection. Eur J Nucl Med Mol Imaging 43, 881–888 (2016). https://doi.org/10.1007/s00259-015-3249-5

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  • DOI: https://doi.org/10.1007/s00259-015-3249-5

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