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핵의학
- 2016년 05월호
[J Nucl Med] Primary Tumor 18F-FDG Avidity Affects the Performance of 18F-FDG PET/CT for Detecting Gastric Cancer Recurrence성균관의대 / 김수정, 이경한*
- 출처
- J Nucl Med
- 등재일
- 2016 Apr
- 저널이슈번호
- 57(4):544-50. doi: 10.2967/jnumed.115.163295. Epub 2015 Dec 17.
- 내용
AbstractThe usefulness of(18)F-FDG PET in gastric cancer recurrence is limited by low sensitivity. Given that detectability by PET is dependent on the tumor's metabolic characteristics, we tested whether the performance of PET for gastric cancer recurrence is enhanced in patients with(18)F-FDG-avid primary tumors.
METHODS:
Three hundred sixty-eight patients with advanced gastric cancer underwent(18)F-FDG PET/CT for initial staging and for recurrence surveillance after curative surgery. On initial PET/CT, primary tumors were(18)F-FDG-avid if they displayed focal uptake with an SUVmax4 or more. Follow-up(18)F-FDG PET/CT was evaluated for recurrent disease.
RESULTS:
On initial PET/CT, the primary tumor was(18)F-FDG-avid in 236 of 368 (64.1%) and nonavid in 132 patients (35.9%). During follow-up for 18.9 ± 13.3 mo, 72 patients (19.6%) had recurrence. Of the 63 PET scans with recurrence, 42 (66.7%) and 21 (33.3%) were scans of patients with(18)F-FDG-avid and nonavid primary tumors, respectively. PET sensitivity was higher in scans of patients with(18)F-FDG-avid than nonavid tumors for all recurrences (81.0% vs. 52.4%;P= 0.018) and nonanastomosis site recurrences (82.1% vs. 47.4%;P= 0.006). The sensitivity for detecting peritoneal recurrence was also higher for the avid tumor group. PET specificity was similarly high (97.1% and 97.5%) for both groups. Adding cell type and Lauren classification to tumor(18)F-FDG avidity further enhanced PET sensitivity.
CONCLUSION:
Surveillance(18)F-FDG PET/CT after resection of gastric cancer has significantly higher sensitivity in patients with(18)F-FDG-avid primary tumors and may have greater value in this group.
Author information
Kim SJ1, Cho YS1, Moon SH1, Bae JM2, Kim S2, Choe YS1, Kim BT1, Lee KH3.
1Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and.
2Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and khnm.lee@samsung.com.
- 키워드
- 18F-FDG-avidity; PET/CT; gastric cancer; recurrence; sensitivity
- 연구소개
- 위암 재발을 진단하는데 있어서 F-18 FDG PET 영상이 유용하지만 낮은 민감도 때문에 제한이 있습니다. 이 논문에서는 원발 위암 종양의 F-18 FDG 섭취증가 여부에 따라 follow up PET 영상의 재발 성적을 비교하였는데 원발 위암 종양에 섭취증가가 있었던 경우 재발 병변 진단의 민감도가 더 높게 나타났습니다. 원발 종양에 F-18 FDG 섭취증가가 있었던 경우, 이후 재발에 대한 추적관찰 F-18 FDG PET이 더 유용할 것임을 연구한 논문입니다.
- 덧글달기
- 이전글 [J Nucl Med] Prognostic Significance of 18F-FDG Uptake in Hepatocellular Carcinoma Treated with Transarterial Chemoembolization or Concurrent Chemoradiotherapy: A Multicenter Retrospective Cohort Study
- 다음글 [J Nucl Med] MRI-Based Attenuation Correction for PET/MRI Using Multiphase Level-Set Method.