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The role of PET/CT in detection of gastric cancer recurrence

Cited 56 time in Web of Science Cited 58 time in Scopus
Authors
Sim, Sung Hoon; Kim, Yu Jung; Oh, Do-Youn; Lee, Se-Hoon; Kim, Dong-Wan; Kang, Won Jun; Im, Seock-Ah; Kim, Tae-You; Kim, Woo-Ho; Heo, Dae Seog; Bang, Yung-Jue
Issue Date
2009-03
Publisher
BioMed Central
Citation
BMC Cancer, Vol.9, p. 73
Keywords
AdultAgedAged, 80 and overFemaleFluorodeoxyglucose F18/diagnostic useHumansMaleMiddle AgedNeoplasm Recurrence, Local/*radiography/*radionuclide imagingPositron-Emission Tomography/methodsRadiopharmaceuticals/diagnostic useSensitivity and SpecificityStomach Neoplasms/*radiography/*radionuclide imaging/surgeryTomography, X-Ray Computed/methods
Abstract
Background: In the course of surveillance of gastric cancer recurrence after curative resection, contrast CT scan is used in general. However, new findings from CT scan are not always confirmatory for the recurrence. In this case, we usually use short-term follow up strategy or therapeutic intervention with clinical decision. Recently, the use of fusion Positron Emission Tomography/Computed Tomography (PET/CT) is increasing. The purpose of this study is to evaluate the efficacy and usefulness of PET/CT for detecting recurrence of gastric cancer after curative resection. Methods: Fifty two patients who received curative resection of gastric cancer and had undergone PET/CT and contrast CT for surveillance of recurrence until Dec 2006 in Seoul National University Hospital were analyzed retrospectively. Recurrence of gastric cancer was validated by histologic confirmation (n = 17) or serial contrast CT follow up with at least 5 month interval (n = 35). McNemar's test and Fisher's exact test were used to evaluate sensitivity and specificity of PET/CT and contrast CT. Results: Of 52 patients, 38 patients were confirmed as recurrence. The sensitivity was 68.4% (26/38) for PET/CT and 89.4% (34/38) for contrast CT (p = 0.057). The specificity was 71.4% (10/14) and 64.2% (9/14), respectively (p = 1.0). In terms of the recurred sites, the sensitivity and specificity of PET/CT were similar to those of contrast CT in all sites except peritoneum. Contrast CT was more sensitive than PET/CT (p = 0.039) for detecting peritoneal seeding. Additional PET/CT on contrast CT showed no further increase of positive predictive value regardless of sites. Among 13 patients whose image findings between two methods were discordant and tissue confirmation was difficult, the treatment decision was made in 7 patients based on PET/CT, showing the final diagnostic accuracy of 42.8% (3/7). Conclusion: PET/CT was as sensitive and specific as contrast CT in detection of recurred gastric cancer except peritoneal seeding. However, additional PET/CT on contrast CT did not increase diagnostic accuracy in detection of recurred gastric cancer. Further studies are warranted to validate the role of PET/ CT in detection of gastric cancer recurrence.
ISSN
1471-2407
Language
English
URI
http://hdl.handle.net/10371/62508
DOI
https://doi.org/10.1186/1471-2407-9-73
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
College of Medicine/School of Medicine (의과대학/대학원)Cancer Research Institute (암연구소)Journal Papers (저널논문_암연구소)
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