Clinical implication of FDG–PET in advanced gastric cancer with signet ring cell histology

Abstract

Although SUVmax of initial PET scan was not an independent predictor of patient outcomes after curative surgery, higher SUVmax is associated with more advanced stage and indicates more aggressive tumor biology in advanced SRC.

Correlation of Primary Tumor FDG Uptake with Histopathologic Features of Advanced Gastric Cancer

“…This discrepancy in the prognostic value of the FDG uptake may result from the study population including different histopathologic types of gastric cancer, because both the diffuse and infiltrative types of gastric adenocarcinomas have a poor prognosis but show lower FDG uptake than the other histopathologic subtypes. In this respect, Pak et al [18] reported that in advanced signet ring cell carcinoma, higher FDG uptake of the primary tumor is associated with a more advanced stage and indicates more aggressive tumor biology. Lee et al [19] performed subgroup analysis according to the WHO classification and demonstrated that patients with negative FDG uptake had a significantly higher recurrence-free survival rate than patients with positive FDG uptake in the tubular adenocarcinoma and papillary adenocarcinoma groups.…”

“…There are controversial, limited data on whether the Borrmann classification affects the FDG uptake and detectability of the primary gastric tumor [18,20,24,29]. Pak et al [18] and Stahl et al [20] reported that the Borrmann classification was not significantly related to the FDG uptake of the primary gastric tumor and tumor detectability. However, Yun et al [24] reported that Borrmann type I had higher FDG uptake than the other three types.…”

“…However, in patients with gastric cancer, there are controversial, limited data on whether the degree of FDG uptake is predictive of prognosis. Some studies reported a longer survival in patients with negative PET than in those with positive PET [17][18][19], whereas other studies could not determine any difference in the survival rate between patients with high and low FDG uptake [20]. Studies according to the histopathological subtypes seem to provide better information on the association between FDG uptake and patient prognosis because histopathologic features could affect the PET/CT visibility and FDG uptake of primary cancer lesions [21][22][23].…”

“…Several studies have reported a correlation between several histopathologic features and the FDG uptake of the primary tumor in patients with gastric cancer [18,19,23,24]. However, previous studies were not sufficient to assess the correlation between several histopathologic features and FDG uptake of the primary tumor because the patients with early gastric cancer or those with only a few specific histopathologic subtypes of gastric cancer were included in these studies.…”

Primary Tumor 18F-FDG Avidity Affects the Performance of 18F-FDG PET/CT for Detecting Gastric Cancer Recurrence

“…For instance, high 18 F-FDG uptake of primary gastric cancers has been shown to be associated with greater aggressiveness and poor patient survival (15,16). The histologic type of the primary tumor may also influence the sensitivity of 18 F-FDG PET for detecting recurrent gastric cancer.…”