Abstract
4065 Background: To assess the value of the whole-body 18-fluorodeoxyglucose positron emission tomography (FDG-PET) scan as a staging modality complementing computer tomography (CT) in patients with known or suspected recurrent gastric adenocarcinoma. Methods: Eighty-seven patients (M:F=61:26)) who underwent curative resection for gastric adenocarcinoma and were referred for postoperative FDG-PET imaging were included in the study. All the patients underwent spiral CT within one month. A final diagnosis was reached by clinical examination, histology or follow up (> 6 months). Results: In a patient-based analysis, FDG-PET correctly identified 46 of 54 patients with recurrence and 31 of 33 without recurrence, resulting in a sensitivity, specificity, and accuracy of 85%, 94%, and 89% respectively. Discordances between FDG-PET and CT findings were found in 27 of 87 patients (31%). Of these, FDG-PET result were correct in 18 (67%) patients, which was higher than that of CT scan (16/27, 59%). In a region-based analysis, 43 regions were discordant between PET and CT, PET detected recurrent lesions in 6 locoregional lesions, 6 hematogenous lesions, 2 peritoneal dissemination, and 6 extra-abdominal lymph node metastases, which were false-negative findings in CT scan. One false-positive finding of peritoneal recurrence in CT scan was corrected by FDG-PET. Overall FDG-PET had additional diagnostic value in 10 (11%) of 87 patients by upstaging 9 (10%) and downstaging 1 (1%) patients. FDG-PET combined with CT had a higher accuracy for detecting recurrent lesions compared to CT or PET alone (98% vs 87%, 98% vs 89%, respectively). Conclusions: The FDG-PET is a useful diagnostic modality for detecting recurrent gastric adenocarcinoma, and can provide information on recurrence site when CT is non-diagnostic. Evaluation with FDG-PET had an impact on the clinical management in the follow-up of patients with gastric cancer. No significant financial relationships to disclose.
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