RCC

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RECURRENCE DETECTION OF F-18 FDG PET IN PATIENTS
WITH STOMACH CANCER ACCORDING TO SUSPECTED
RECURRENCE SITE BI Kim,1 HY Bang,2 JI Lee,2
GJ Cheon,1 CW Choi,1 SM Lim,1 SW Hong1
Departments of ¹Nuclear Medicine and ²Surgery,
Korea Institute of Radiological and Medical
Sciences, Seoul, Korea
Introduction
Stomach cancer most common malignancy in South
Korea pattern of recurrence is diverse tumor
maker (CEA, CA19-9) cannot localize
recurrence imaging evaluation is important FDG
PET sensitive diagnostic imaging tool it has
some physiologic activity such as bowel, reactive
lymphadenopathy The purpose of this study to
investigate recurrence detection of FDG PET in
patients with stomach cancer according to
suspected recurrence site

• PET findings and results in anastomotic sites

Methods
Patients From Feb. 1998 to Apr. 2002 31
patients suspicious recurred stomach cancer who
had been performed curative gastrectomy M F
15 16 Age 53 12 yrs F-18 FDG Whole body
PET Divided into 8 Regions Anastomotic site /
Regional LNs / Bowel / Liver / Bone /
Neck / Lung / Mediastinum Positive criteria
any focal uptake in each Region Each positive
predictable value according to regions were
confirmed by Positive findings Pathologic or
follow up study Negative findings Follow up
at least 6 months Conventional Study Endoscopic
Bx / Abdominal CT / USG / Chest PA / CT / Bone
Scan The accuracy of recurrence detection was
compared between PET and Conventional Study.
Subtotal intense focal TP
Subtotal intense diffuse FP
Subtotal intense focal FP
Total mild diffuse TP
Subtotal mild diffue FP

• PET findings and results in Bowel / Mediastinum

lt MIP images gt
Mediastinal asymmetrical uptakes FP
Mediastinal asymmetrical uptakes TP
focal intense bowel uptake TP
focal intense bowel uptake FP
Results
Conclusion and Discussion

• Overall accuracy to detect recurrence except
  anastomotic site

FDG PET
Conventional Study
FDG PET was useful in detecting recurrence in
patients with stomach cancer compared to
Conventional Study. However, there were
considerable false positives in anastomotic
site in case of subtotal gastrectomy, bowel,
lung, and mediastinum, Careful decision should
be done in these sites.
()
(-)
()
(-)
()
17
4
10
11
Recurrence
(-)
4
4
0
8
Sensitivity
81
48
Specificity
50
100
There was a statistical significance between
two studies (p 0.003, McNemar test)
Korea Institute of Radiological and Medical
Sciences