The Role of PET-CT in Gastric Cancer — A Narrative Review
Keywords:
gastric cancer (GC), PET-CT, 18-FDG PET-CT, 18F-FDG uptake, ceCT (contrast-enhanced CT)
Abstract
Background: Gastric cancer is one of the most common and leading causes of cancer death worldwide, with an increasing risk and prevalence. Although the usage of 18-FDG PET-CT in gastric cancer evaluation remains a matter of debate and is not consistently recommended by international guidelines, our descriptive review aims to highlight its actual role in the diagnostic accuracy, staging, therapeutic management, and relapse monitoring of this malignancy.
Methods: The current research was conducted using scholarly databases including PubMed, Scopus, and Google Scholar by searching useful science journals, references, and abstracts on the topic. The keywords used were “gastric cancer” AND “PET-CT”.
Results: 18-FDG PET-CT remains a promising method with increasing clinical utility not only across a wide variety of malignancies, but also among gastric cancer patients.
Conclusions: We are certain that with further improvements, this technique could improve the diagnosis and evaluation of gastric cancer, and make it more approachable and accurate.
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Medicine and Molecular Imaging, vol. 38, no. 1, pp. 64–73.
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vol. 35, no. 5, pp. 449–455.
ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. Annals
of Oncology, vol. 24, no. 6.
[2] Yamada, T., Alpers, D. H., Kalloo, A. N., et al. (2009). Textbook of Gastroenterology
(5th ed.), vol. 1–2, Blackwell Publishing Ltd, USA
[3] De Raffele, E., Mirarchi, M., Cuicchi, D., et al. (2017). Evolving role of FDG-
PET/CT in prognostic evaluation of resectable gastric cancer. World Journal of Gastroenterology, vol. 23, no. 38, pp. 6923–6926.
[4] Wu, C. X. and Zhu, Z. H. (2014). Diagnosis and evaluation of gastric cancer by
positron emission tomography. World Journal of Gastroenterology, vol. 20, no. 16,
pp. 4574–4585.
[5] Song, B. I., Kim, H. W., Won, K. S., et al. (2015). Preoperative standardized uptake value
of metastatic lymph nodes measured by 18F-FDG PET/CT improves the prediction
of prognosis in gastric cancer. Medicine, vol. 94, no. 26., pp 1-8
[6] Malibari, N., Hickeson, M., and Lisbona R. (2015). PET/computed tomography in the
diagnosis and staging of gastric cancers. PET Clinics, vol. 10, no. 3, pp. 311–326.
[7] Atay-Rosenthal S., Wahl, R. L., and Fishman, E. K. (2012). PET/CT findings in gastric
cancer: potential advantages and current limitations. Imaging in Medicine, vol. 4, no.
2. Retrieved from: https://www.openaccessjournals.com/articles/petct-findings-
in-gastric-cancer-potential-advantages-and-current-limitations.html?fbclid=
IwAR1fmJh5yTSlzly2PpLkcckmVZn0SpLu4za9zeLJ866agHGZvRLvsPmFj5I
[accessed on December 16, 2019].
[8] Mukai, K., Ishida, Y., Okajima, K., et al. (2006). Usefulness of preoperative FDG-PET
for detection of gastric cancer. Gastric Cancer, vol. 9, no. 3, pp. 192–196.
[9] Filik, M., Kir, K. M., Aksel, B., et al. (2015). The role of 18F-FDG PET/CT in the Primary
staging of gastric cancer. Molecular Imaging and Radionuclide Therapy, vol. 24, no.
1, pp. 15–20.
[10] Yeung, H. W. D., Macapinlac, H., Karpeh, M., et al. Accuracy of FDG-PET in gastric
cancer. preliminary experience. Molecular Imaging and Biology, vol. 1, no. 4, pp.
213–221.
[11] Kim, E. Y., Lee, W. J., Choi, D., et al. (2011). The value of PET/CT for preoperative
staging of advanced gastric cancer: comparison with contrast-enhanced CT.
European Journal of Radiology, vol. 79, no. 2, pp. 183–188.
[12] Shimizu, K., Ito, K., Matsunaga, N., et al. (2005). Diagnosis of gastric cancer with
MDCT using the water-filling method and multiplanar reconstruction: CT-histologic
correlation. American Journal of Roentgenology, vol. 185, no. 5, pp. 1152–1158.
[13] Perlaza, P., Ortín, J., Pagès, M., et al. (2018). Should 18F-FDG PET/CT Be routinely
performed in the clinical staging of locally advanced gastric adenocarcinoma?
Clinical Nuclear Medicine, vol. 43, no. 6, pp. 402–410.
[14] Yun, M., Lim, J. S., Noh, S. H., et al. (2005). Lymph node staging of gastric cancer
using 18F-FDG PET: a comparison study with CT. Journal of Nuclear Medicine, vol.
46, no. 10, pp. 1582–1588.
[15] Tamura, S., Takeno, A., and Miki, H. (2011). Lymph node dissection in curative
gastrectomy for advanced gastric cancer. International Journal of Surgical Oncology,
vol. 2011, no. 1 pp. 1–8.
[16] Kwee, R. M. and Kwee, T. C. (2009). Imaging in assessing lymph node status in
gastric cancer. Gastric Cancer, vol. 12, no. 1. pp. 6–22.
[17] Seevaratnam, R., Cardoso, R., McGregor, C., et al. (2012). How useful is preoperative
imaging for tumor, node, metastasis (TNM) staging of gastric cancer? A meta-
analysis. Gastric Cancer, vol. 15, no.1, pp. S3–S18.
[18] Ha, T. K., Choi, Y. Y., Song, S. Y., et al. (2011). F18-fluorodeoxyglucose-positron
emission tomography and computed tomography is not accurate in preoperative
staging of gastric cancer. Journal of Korean Surgical Society, vol. 81, no. 2, pp.
104–110.
[19] Hopkins, S. and Yang, G. Y. (2011). FDG PET imaging in the staging and management
of gastric cancer. Journal of Gastrointestinal Oncology, vol. 2, no. 1, pp. 39–44.
[20] Chung, H. W., Lee, E. J., Cho, Y.-H., et al. (2010). High FDG uptake in PET/CT predicts
worse prognosis in patients with metastatic gastric adenocarcinoma. Journal of
Cancer Research and Clinical Oncology, vol. 136, no. 12, pp. 1929–1935.
[21] Ma, D. W., Kim, J.-H., Jeon, T. J., et al. (2013). 18F-fluorodeoxyglucose positron
emission tomography-computed tomography for the evaluation of bone metastasis
in patients with gastric cancer. Digestive and Liver Disease, vol. 45, no. 9, pp. 769–
775.
[22] Wang, Z. and Chen, J. Q. (2011). Imaging in assessing hepatic and peritoneal
metastases of gastric cancer: a systematic review. BMC Gastroenterology, vol. 11,
no,1 , p. 19.
[23] Smyth, E., Schöder, H., Strong, V. E., et al. (2012). A prospective evaluation of the utility
of 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography and computed
tomography in staging locally advanced gastric cancer. Cancer, vol. 118, no. 22. pp.
5481–5488.
[24] Yun, M. (2014). Imaging of gastric cancer metabolism using 18 F-FDG PET/CT. Journal
of Gastric Cancer, vol. 14, no. 1, pp. 1–6.
[25] Cayvarl????, H., Bekiş, R., Akman, T., et al. (2014). The role of 18F-FDG PET/CT in
the evaluation of gastric cancer recurrence. Molecular Imaging and Radionuclide
Therapy, vol. 23, no. 3, pp. 76–83.
[26] Lee, J. W., Lee, S. M., Lee, M. S., et al. (2012). Role of 18F-FDG PET/CT in the prediction
of gastric cancer recurrence after curative surgical resection. European Journal of
Nuclear Medicine and Molecular Imaging, vol. 39, no. 9, pp. 1425–1434.
[27] Sim, S. H., Yu, J. K., Oh D.-Y., et al. (2009). The role of PET/CT in detection of gastric
cancer recurrence. BMC Cancer, vol. 9, p. 73.
[28] Wu, L. M., Hu, J. N., Hua, J., et al. (2012). 18F-fluorodeoxyglucose positron emission
tomography to evaluate recurrent gastric cancer: a systematic review and meta-
analysis. European Journal of Gastroenterology & Hepatology, vol. 27, no. 3, pp.
472–480.
[29] Zou, H. and Zhao, Y. (2013). 18FDG PET-CT for detecting gastric cancer recurrence
after surgical resection: a meta-analysis. Surgical Oncology, vol. 22, no. 3, pp. 162–
166.
[30] Bilici, A., et al. (2011). The role of 18F-FDG PET/CT in the assessment of suspected
recurrent gastric cancer after initial surgical resection: can the results of FDG
PET/CT influence patients’ treatment decision making? European Journal of Nuclear
Medicine and Molecular Imaging, vol. 38, no. 1, pp. 64–73.
[31] Dassen, A. E., Lips, D. J., Hoekstra, C. J., et al. (2009). FDG-PET has no definite role
in preoperative imaging in gastric cancer. European Journal of Surgical Oncology,
vol. 35, no. 5, pp. 449–455.
