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

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 intervent...

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Autores principales: 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
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2651906/
https://www.ncbi.nlm.nih.gov/pubmed/19250554
http://dx.doi.org/10.1186/1471-2407-9-73
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author 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
author_facet 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
author_sort Sim, Sung Hoon
collection PubMed
description 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.
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spelling pubmed-26519062009-03-06 The role of PET/CT in detection of gastric cancer recurrence 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 BMC Cancer Research Article 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. BioMed Central 2009-03-01 /pmc/articles/PMC2651906/ /pubmed/19250554 http://dx.doi.org/10.1186/1471-2407-9-73 Text en Copyright ©2009 Sim et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
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
The role of PET/CT in detection of gastric cancer recurrence
title The role of PET/CT in detection of gastric cancer recurrence
title_full The role of PET/CT in detection of gastric cancer recurrence
title_fullStr The role of PET/CT in detection of gastric cancer recurrence
title_full_unstemmed The role of PET/CT in detection of gastric cancer recurrence
title_short The role of PET/CT in detection of gastric cancer recurrence
title_sort role of pet/ct in detection of gastric cancer recurrence
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2651906/
https://www.ncbi.nlm.nih.gov/pubmed/19250554
http://dx.doi.org/10.1186/1471-2407-9-73
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