Department of Oncological Surgery, Oncological Centre, Bydgoszcz, Poland.
Department of Nuclear Medicine, Oncological Centre, Bydgoszcz, Poland.
Abdom Radiol (NY). 2016 Jul;41(7):1349-56. doi: 10.1007/s00261-016-0647-5.
To date, no data are available on the use of 18-fluorothymidine positron emission tomography/computed tomography (FLT-PET/CT) for preoperative gastric cancer staging. Herein, we attempt to assess the value of FLT-PET/CT for preoperative gastric cancer staging in comparison with contrast-enhanced computed tomography (CECT).
In a group of 96 gastric cancer patients, 96 FLT-PET/CT, 56 abdominal cavity CECT, and 51 resective operations were done. All three (FLT-PET/CT, CECT, and resective operation) were done in 29 patients. The results of FLT-PET/CT, CECT, and histopathological examinations were used to assess the ability of FLT-PET/CT and CECT to identify primary tumors, regional nodal metastases, and distant abdominal metastases. Assessment of regional lymph nodes was based on SUVmax in FLT-PET/CT and SAD (short-axis diameter) in CECT.
In the group of 56 patients examined with FLT-PET/CT and CECT, identification of the primary tumor was possible in 56 cases (100%) and in 53 cases (94.6%), respectively, (p = 0.013). Using ROC curve, the sensitivity and specificity of FLT-PET/CT in metastatic regional lymph node assessment were higher than those of CECT (p = 0.0033). FLT-PE/CT enabled identification of a greater number of extraregional abdominal metastases than CECT (n = 56; 19 vs. 15, respectively), but the difference was not statistically significant (p > 0.41).
The ability of FLT-PET/CT to identify primary tumors is greater than that of CECT, and thus FLT-PET/CT was better in evaluating regional nodal metastases. FLT-PET/CT enabled identification of a greater number of abdominal metastases than CECT, but the difference was not statistically significant.
目前尚无氟代胸苷正电子发射断层扫描/计算机断层扫描（FLT-PET/CT）用于术前胃癌分期的相关数据。本研究旨在评估 FLT-PET/CT 与增强 CT（CECT）在术前胃癌分期中的应用价值。
在 96 例胃癌患者中，进行了 96 次 FLT-PET/CT、56 次腹腔 CECT 和 51 次手术。29 例患者同时进行了 FLT-PET/CT、CECT 和手术。根据 FLT-PET/CT、CECT 和组织病理学检查的结果，评估 FLT-PET/CT 和 CECT 对识别原发肿瘤、区域淋巴结转移和远处腹部转移的能力。FLT-PET/CT 中采用 SUVmax，CECT 中采用 SAD（短轴直径）评估区域淋巴结。
在接受 FLT-PET/CT 和 CECT 检查的 56 例患者中，56 例（100%）和 53 例（94.6%）患者可识别原发肿瘤（p=0.013）。ROC 曲线显示，FLT-PET/CT 在转移性区域淋巴结评估中的敏感性和特异性均高于 CECT（p=0.0033）。FLT-PET/CT 比 CECT 识别出更多的腹腔外转移（n=56；19 比 15），但差异无统计学意义（p>0.41）。
FLT-PET/CT 识别原发肿瘤的能力强于 CECT，因此在评估区域淋巴结转移方面更有优势。FLT-PET/CT 比 CECT 能识别出更多的腹部转移，但差异无统计学意义。
