Evaluation of Recurrent Gastric Malignancy with [F-18]-FDG Positron Emission Tomography

Jadvar, Hossein; Tatlidil, Rozet; García, Agustin A.; Conti, Peter S.

doi:10.1016/s0009-9260(02)00477-4

Cited by 70 publications

(41 citation statements)

References 25 publications

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“…Experience with this technique in patients with gastric carcinoma is very limited. Most of the studies focused on recurrent gastric cancer or locally advanced disease (22)(23)(24)(25). They all found a low sensitivity and specificity to detect recurrence or locally advanced disease, with figures around 70%.…”

Section: Discussionmentioning

confidence: 99%

[18F]Fluoro-2-deoxy-d-glucose Positron Emission Tomography Detects Gastric Carcinoma in an Early Stage in an Asymptomatic E-Cadherin Mutation Carrier

Kouwen¹,

Drenth

Oyen³

et al. 2004

Clinical Cancer Research

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Purpose: Autosomal dominant hereditary diffuse gastric cancer (HDGC) is caused by germ-line E-cadherin (CDH1) gene mutations. Early detection of cancer in carri-Conclusions: We present an asymptomatic patient from a HDGC family carrying a novel CDH1 mutation in whom FDG-PET scanning facilitated early detection of HDGC. This calls for further investigation of the role of FDG-PET scan as a screening modality in HDGC.

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Section: Discussionmentioning

confidence: 99%

[18F]Fluoro-2-deoxy-d-glucose Positron Emission Tomography Detects Gastric Carcinoma in an Early Stage in an Asymptomatic E-Cadherin Mutation Carrier

Kouwen¹,

Drenth

Oyen³

et al. 2004

Clinical Cancer Research

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“…Therefore, evaluation of the anastomotic site of gastroduodenostomy in the remnant stomach is important for detection of locoregional recurrence of gastric cancer. No available data focus on the anastomotic site, and the reported studies of FDG PET/CT for detecting gastric cancer recurrence focused only on the focal increased F-18 FDG uptake lesion relative to the normal biodistribution of background F-18 FDG uptake in the remnant stomach [3,6,8,12,19,25].…”

Section: Discussionmentioning

confidence: 99%

Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer

Choi

Zeon

Kim

et al. 2011

Nucl Med Mol Imaging

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Purpose The aim of this study was to characterize the patterns of fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography/computed tomography (FDG PET/CT) at the anastomotic site of gastroduodenostomy after distal subtotal gastrectomy in patients with gastric cancer. Methods From May 2007 to May 2010, two or more follow-up measurements using FDG PET/CT scans were done for 19 patients (11 men, 8 women; mean age, 62.0± 10.3 years) who underwent distal subtotal gastrectomy with gastroduodenostomy between February 2006 and March 2008 for detecting gastric cancer recurrence at our medical center. The FDG PET/CT images were retrospectively reviewed. Patients with local recurrence, regional nodal metastasis or distant metastasis on follow-up studies were excluded. CT and endoscopy were done within 1 month before or after the FDG PET/CT scan. Eight patients had two follow-ups of FDG PET/CT, and 11 patients had three follow-ups. The mean interval between surgery and the first follow-up FDG PET/CT was 12.9±0.8 months (n=19); between the first and second it was 12.3±1.0 months (n= 19); between the second and third it was 11.6±0.7 months (n=11). The F-18 FDG uptakes at the anastomotic site and fundus in the remnant stomach were measured by maximum standardized uptake value (SUVmax) using a region of interest technique.Results The SUVmax at the anastomotic site was significantly higher than that of the fundus on all series of first, second and third follow-up studies (3.3±1.1 vs. 2.1±0.7, p<0.001: 3.1±0.9 vs. 2.2±0.7, p=0.001: 3.0±0.6 vs. 2.1±0.7, p=0.006, respectively). The SUVmax for the anastomotic site and fundus, and SUVmax ratio for the anastomotic site over the fundus were not significantly different throughout the series. Conclusion The SUVmax at the anastomotic site is significantly higher than that of the fundus and does not decrease significantly over time. Therefore, the local recurrence of gastric cancer after surgery could not be definitely differentiated from physiologic uptake or postoperative inflammatory change.

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“…Recently, PET-CT, which has the advantage of being able to detect lesions that are not distinguished by CT, was introduced. PET-CT may be useful for gastric cancer patients in whom there is a clinical suspicion of recurrence [5]. However, PET-CT has limitations for the detection of recurrence if the histopathologic types of gastric cancer are mucinous and signet ring cell carcinoma, as well as poorly differentiated adenocarcinoma [6].…”

Section: Discussionmentioning

confidence: 99%

Duodenal stump cancer after Billroth-II distal gastrectomy for gastric cancer

Lee

Kim

2009

Gastric Cancer

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EGC have a risk of developing a second primary (metachronous) cancer, such as colorectal, lung, or liver cancer [1][2][3].The duodenal stump after Billroth II (B-II) distal gastrectomy is a rare site for cancer recurrence unless a tumor-free margin has not been achieved. Moreover, to our knowledge, there are no previously published studies regarding the occurrence of recurrent or metachronous cancer at the duodenal stump. Here, we describe duodenal stump cancer that occurred after a B-II distal gastrectomy for advanced gastric cancer (AGC), particularly focusing on the diffi culties associated with distinguishing recurrent gastric cancer from metachronous duodenal cancer. Case reportA 68-year-old man who had undergone distal gastrectomy with B-II type gastrojejunostomy for AGC in June 2005, presented with abrupt onset of dizziness and tarry stool in June 2008. The previously removed tumor was 8.5 × 7.5 cm in size, and located in the posterior wall of the mid-body portion of the stomach, and there was no duodenal lesion on the gastrofi berscopic (GFS) examination that had been performed before the gastrectomy. Pathologic examination revealed that the gastric lesion was a poorly differentiated adenocarcinoma infi ltrating the subserosa, accompanied by multiple lymph node metastases (48 of 77 retrieved nodes were metastatic); the duodenum was resected, using a linear stapler, about 2 cm below the pyloric ring. The proximal and distal resected margins were 1.5 cm and 8.0 cm, respectively. Subsequently, six cycles of adjuvant chemotherapy, including 5-fl uorouracil (FU), epirubicin, and cisplatinum, were performed without any problems. The patient was followed up every 6 months by tumor marker analysis, ultrasonography, and computed tomography (CT) and his last checkup had been in January 2008. During Abstract Duodenal cancer is an uncommon neoplasm and it mostly arises from the periampullary area. However, metachronous or even recurrent cancer at the duodenal stump following Billroth II type distal gastrec tomy for gastric cancer is extremely rare and, to our knowledge, has not yet been reported. A 68-year-old man underwent Billroth II distal gastrectomy with D2 lymph node dissection for an advanced gastric cancer. At that time the tumor stage was T2bN3M0, with 44 of 78 retrieved lymph nodes showing metastasis. He was well without recurrence for 3 years; however, he visited our hospital because of the abrupt onset of dizziness and tarry stool. A polypoid tumor that bled easily when touched was found at the end of the afferent loop of the duodenal stump by gastrofi berscopic examination, and it was proven to be an adenocarcinoma by endoscopic biopsy. Fortunately, additional studies, including abdominal computed tomography and positron emission tomography-computed tomography, showed no other sites of recurrence. The patient underwent pancreaticoduodenectomy for local control of the recurrent tumor at the duodenal stump, and the pathologic fi ndings, based on immunohistochemical staining, strongly suggested that the du...

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Evaluation of Recurrent Gastric Malignancy with [F-18]-FDG Positron Emission Tomography

Cited by 70 publications

References 25 publications

[18F]Fluoro-2-deoxy-d-glucose Positron Emission Tomography Detects Gastric Carcinoma in an Early Stage in an Asymptomatic E-Cadherin Mutation Carrier

[18F]Fluoro-2-deoxy-d-glucose Positron Emission Tomography Detects Gastric Carcinoma in an Early Stage in an Asymptomatic E-Cadherin Mutation Carrier

Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer

Duodenal stump cancer after Billroth-II distal gastrectomy for gastric cancer

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