FDG-PET has no definite role in preoperative imaging in gastric cancer

Abstract Background Gastric cancer is fourth on the incidence list of cancers worldwide with a high disease-related mortality rate. Curation can only be achieved by a radical resection including an adequate lymphadenectomy. However, prognosis remains poor and cancer recurrence rates are high, also d...

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Bibliographic Details
Published in:European journal of surgical oncology 2009-05, Vol.35 (5), p.449-455
Main Authors: Dassen, A.E, Lips, D.J, Hoekstra, C.J, Pruijt, J.F.M, Bosscha, K
Format: Article
Language:English
Subjects:
Chemotherapy, Adjuvant
FDG-PET
Fluorodeoxyglucose F18
Gastric cancer
Hematology, Oncology and Palliative Medicine
Humans
Neoadjuvant Therapy
Neoplasm Staging
Preoperative Care
Radiopharmaceuticals
Response monitoring
Review
Sensitivity and Specificity
Staging
Stomach Neoplasms - diagnostic imaging
Stomach Neoplasms - drug therapy
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Surgery
Tomography, Emission-Computed - methods
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Summary:Abstract Background Gastric cancer is fourth on the incidence list of cancers worldwide with a high disease-related mortality rate. Curation can only be achieved by a radical resection including an adequate lymphadenectomy. However, prognosis remains poor and cancer recurrence rates are high, also due to lymph node metastases. To improve outcome, (neo)adjuvant treatment strategies with chemo- and/or radiotherapy regimes are employed. Aims Accurate staging of gastric cancer at primary diagnosis is essential for adequate treatment. In this non-systematic review the role 18-F-Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) in preoperative staging is investigated. Furthermore, the results of neoadjuvant chemotherapy-induced tumour response monitoring by FDG-PET are discussed. Results and conclusion It is concluded that currently FDG-PET has no role in the primary detection of gastric cancer due to its low sensitivity. FDG-PET shows, however, slightly better results in the evaluation of lymph node metastases in gastric cancer compared to CT and could have therefore a role in the preoperative staging. Improvement in accuracy could be achieved by using PET/CT or other PET tracers than FDG, but these modalities need further investigation. FDG-PET, however, adequately detects therapy responders at an early stage following neoadjuvant chemotherapy.
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2008.11.010