Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Republic of Korea.
Eur J Radiol. 2013 Jun;82(6):935-42. doi: 10.1016/j.ejrad.2013.01.014. Epub 2013 Feb 12.
We aimed to improve diagnostic accuracy of (18)F-fluoro-2-deoxyglucose (FDG) PET/CT for gastric cancer with water gastric inflation.
44 gastric cancer patients (M:F=30:14, age ± std=62.1 ± 14.5 y) were enrolled before surgery. Fifty minutes after injection of FDG (0.14 mCi/kg body weight), whole body PET/CT was performed first and then regional PET/CT over gastric area was obtained 80 min post FDG injection after water gastric inflation. Diagnostic accuracies for loco-regional lesions were compared between whole body and regional PET/CT.
48 primary tumors (23 EGC and 25 AGC) and 348 LN stations (61 metastatic and 287 benign) in 44 patients were investigated. Primary tumor sensitivity of whole body PET/CT (50%=24/48) was significantly improved by regional PET/CT (75%=36/48, p<0.005). Sensitivity of whole body PET/CT (24.6%=15/61) for LN metastasis was also significantly improved by regional PET/CT (36.1%=22/61, p<0.01), whereas specificity of whole body PET/CT (99.3%=285/287) was not compromised by regional PET/CT (98.3%=282/287, p>0.05). Higher primary tumor FDG uptake in regional PET/CT indicated shorter progress-free survival (p=0.0003).
Diagnostic accuracy of whole body PET/CT for loco-regional disease of gastric cancer could be significantly improved by regional PET/CT after water gastric inflation and prognosis could be effectively predicted by primary tumor FDG uptake in regional PET/CT.
通过水胃充气提高（18）F-氟代-2-脱氧葡萄糖（FDG）PET/CT 对胃癌的诊断准确性。
44 例胃癌患者（男/女=30/14，年龄±标准差=62.1±14.5 岁）在术前入组。FDG 注射后 50 分钟（0.14mCi/kg 体重），首先进行全身 PET/CT，然后在 FDG 注射后 80 分钟进行水胃充气后进行胃区局部 PET/CT。比较全身和局部 PET/CT 对局部病变的诊断准确性。
44 例患者共检测到 48 个原发肿瘤（23 个 EGC 和 25 个 AGC）和 348 个淋巴结站（61 个转移和 287 个良性）。全身 PET/CT 对原发肿瘤的敏感性（50%=24/48）通过局部 PET/CT 显著提高（75%=36/48，p<0.005）。全身 PET/CT 对淋巴结转移的敏感性（24.6%=15/61）也通过局部 PET/CT 显著提高（36.1%=22/61，p<0.01），而全身 PET/CT 的特异性（99.3%=285/287）不受局部 PET/CT 影响（98.3%=282/287，p>0.05）。局部 PET/CT 中原发肿瘤的 FDG 摄取较高与无进展生存期较短相关（p=0.0003）。
水胃充气后的局部 PET/CT 可显著提高全身 PET/CT 对胃癌局部区域疾病的诊断准确性，并可通过局部 PET/CT 中原发肿瘤的 FDG 摄取有效预测预后。
