Diagnostic role of 18F-FDG PET/CT in recurrence detection of surgically treated gastric cancer: a cross-sectional study

Amr A Elfattah Hassan Gadalla,Nahla Dessoki Elsayed,Mohamed Diaa Sarhan,Mohamed Fouad Osman,Noha Elmansy

doi:10.1186/s43055-019-0080-1

Amr A Elfattah Hassan Gadalla, Nahla Dessoki Elsayed + Show 3 more

Open Access

https://doi.org/10.1186/s43055-019-0080-1

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Abstract

BackgroundRadical surgery of gastric cancer is considered as the only curative treatment; however, its poor long-term survival is often occurred due to its recurrence either local and/or distant metastasis. Thus, early detection of recurrence helps in improving the prognosis. Our aim is to assess the diagnostic role of 18F-FDG PET/CT for detecting postoperative recurrence in gastric cancer patients who have a radiological and/or clinical suspicion of recurrence.ResultsThe study was carried over 31 males (62%) and 19 females (38%) pathologically proven with gastric carcinoma and underwent surgical intervention. All patients underwent PET/CT scan where the site and number of positive FDG activity analyzed. The sensitivity, specificity, and accuracy for locoregional recurrence were 75%, 81.58%, and 85% with p value 0.001; for regional lymph node recurrence were 100%, 100%, and 100% with p value < 0.001; for liver metastasis were 100%, 100%, and 100% with p value < 0.001; for peritoneum metastasis were 100%, 97.38%, and 98% with p value < 0.001; and for distant metastasis were 100%, 85.7%, and 94% with p value < 0.001.ConclusionWith agreements to many studies, this study confirms that FDG PET/CT is a highly effective modality for postoperative surveillance detection of recurrent gastric cancer, especially in patients with clinically manifested disease, elevated tumor markers, and an indication of distant metastasis at diagnostic CT.

Highlights

Radical surgery of gastric cancer is considered as the only curative treatment; its poor longterm survival is often occurred due to its recurrence either local and/or distant metastasis
Among the 50 patients evaluated in this study, a recurrent disease was detected in 34 patients, and 16 patients were negative for recurrence
In all of five groups, the diagnostic accuracy rates were higher than 80%, which was up to 100% in detecting regional lymph nodes and liver metastasis (Fig. 1)

Summary

Introduction

Radical surgery of gastric cancer is considered as the only curative treatment; its poor longterm survival is often occurred due to its recurrence either local and/or distant metastasis. Early detection of recurrence helps in improving the prognosis. Gastric cancer is the second leading cause of death from malignant disease worldwide and the most frequently discovered in advanced stages. Gastric tumors are subdivided into those of epithelial or stromal origin. Rarer gastric malignancies include gastrointestinal stromal tumors (GIST), lymphomas, and neuroendocrine tumors [1, 2]. Surgical resection and lymph node dissection remain the definitive therapy for complete cure or longterm survival in case of local disease without distant metastasis [2, 3]. Pathological recurrence has a bad prognosis, and 5-year survival rate remains under 20%. Early detection of disease recurrence is important and improves

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