High FDG uptake in PET/CT predicts worse prognosis in patients with metastatic gastric adenocarcinoma

Chung, Hyun Woo; Lee, Eun Jeong; Cho, Yo-Han; Yoon, So Young; So, Young; Kim, Sung-Yong; Lee, Mark Hong; Kim, Jeong Hwan; Lee, Sun-Young; Sung, In‐Kyung; Park, Hyung-Seok; Yoo, Moon‐Won; Lee, Kyung-Yung

doi:10.1007/s00432-010-0852-5

Cited by 55 publications

(47 citation statements)

References 27 publications

(34 reference statements)

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“…While FLT-PET performed as an unsatisfying tracer when judged locally in the liver, the high background hepatic uptake could interfere with lesion imaging. For patients with a primary gastric lesion, some Korean studies found high FDG uptake of primary tumor was a robust prognostic factor in patients with metastatic gastric cancer (26,27). In our study, we also found that FDG-uptake change in primary gastric cancer showed a prognostic impact for PFS and OS.…”

Section: Discussionsupporting

confidence: 80%

The Predictive and Prognostic Value of Early Metabolic Response Assessed by Positron Emission Tomography in Advanced Gastric Cancer Treated with Chemotherapy

Wang

Guo

Zhou

et al. 2016

Clinical Cancer Research

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Purpose: To evaluate the feasibility of early metabolic change assessed by PET in predicting clinical response to chemotherapy and investigate its prognostic value in patients with advanced gastric cancer.Experimental Design: A total of 64 patients with advanced gastric cancer were prospectively enrolled and examined by PET with 18 F-fluorodeoxyglucose (FDG) and 18 F-fluoro-3 0 -deoxy-3 0 -Lfluorothymidine (FLT) at baseline and 14 days after treatment initiation. PET findings were analyzed for the correlation with best clinical response of patients, disease control status, and survival after identifying the threshold of metabolic change percentage by ROC analysis.Results: For FDG-PET, the total uptake value reduction percentage (d-SUV) of 40% was the cut-off point with the maximum of sensitivity (70%) and specificity (83%) to predict clinical responding and that of prediction for disease control status was 30%, with the highest sensitivity (58%) and specificity (100%). The d-SUV of FLT-PET played no predictive role for clinical response (AUC ¼ 0.62; P ¼ 0.134) and disease control (AUC ¼ 0.66; P ¼ 0.157). The univariate Cox regression analysis revealed no significant prognostic impact. FDG uptake reduction in liver metastases could predict both clinical response (P ¼ 0.010) and disease control status (P ¼ 0.002) at thresholds of 35% and 15%, respectively. Those with greater FDG uptake reduction in liver lesions had a longer overall survival (P ¼ 0.004).Conclusions: Early metabolic change in FDG-PET might be a predictive marker for response and disease control in advanced gastric cancer. Early FDG uptake change in liver metastases might be a useful prognostic factor and needs further exploration.

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Section: Discussionsupporting

confidence: 80%

The Predictive and Prognostic Value of Early Metabolic Response Assessed by Positron Emission Tomography in Advanced Gastric Cancer Treated with Chemotherapy

Wang

Guo

Zhou

et al. 2016

Clinical Cancer Research

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“…FDG-PET/CT imaging is expected to provide more precise anatomical data in addition to metabolic information. For gastric cancers, FDG-PET imaging provides important additional information concerning the prognosis of recurrent cancer, including lymph node metastases, peritoneal carcinomatosis, distant metastasis, tumor response to treatment, and overall survival [3][4][5][6][7][8][9][10]. However, some subtypes of gastric cancer exhibit reduced FDG uptake [3,[11][12][13][14], which significantly limits the use of PET in gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Gastric cancers with microsatellite instability exhibit high fluorodeoxyglucose uptake on positron emission tomography

et al. 2012

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Background Gastric cancers exhibit various degrees of 18 F-fluorodeoxyglucose (FDG) uptakes on positron emission tomography/computed tomography (PET/CT) imaging. The aim of this study was to evaluate whether FDG uptake in gastric cancer varies according to the microsatellite instability (MSI) status. Methods Consecutive gastric cancer patients who underwent PET/CT imaging and MSI analysis were included in the study. The maximum standardized uptake value (SUV max ) of gastric cancer was assessed using PET/CT imaging. Results Of 131 gastric cancers, 16 exhibited a high incidence of MSI (MSI-H) and 3 exhibited a low incidence of MSI (MSI-L). In 29 subjects who showed no uptake on PET/CT imaging the gastric cancers were all microsatellite stable (MSS). Gastric cancers with MSI were related to age older than 60 years (p = 0.002), cancer volume larger than 10 cm 3 (p = 0.015), and the presence of FDG uptake on PET/CT imaging (p = 0.001). A higher SUV max of gastric cancer was linked to the presence of MSI (p \ 0.001). Conclusion The presence of MSI is related to FDG uptake in gastric cancer. Care should be taken with MSS gastric cancers, because they show lower SUV max on PET/ CT imaging than MSI gastric cancers.

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“…In addition, some researchers have suggested that metabolic activity on FDG-PET may be a predictive marker for some types of malignancies [6][7][8][9] . Recent studies have demonstrated that there is a correlation between the maximum standardized uptake value (SUVmax) and survival in patients with gastrointestinal cancers such as esophageal and stomach cancer [10][11][12] . However, the prognostic value of FDG-PET/CT for colorectal cancer is less well studied.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of 18-fluorodeoxyglucose positron emission tomography-computed tomography in resectable colorectal cancer

Lee

Kim²,

Kim³

et al. 2012

WJG

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AIM:To assess the prognostic value of preoperative 18 fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) in patients with resectable colorectal cancer. METHODS:One hundred sixty-three patients with resectable colorectal cancer who underwent FDG-PET/CT before surgery were included. Patient data including pathologic stage at presentation, histology, treatment, disease-free survival and the maximum standardized uptake value (SUVmax) of the primary tumor on FDG-PET/CT were retrospectively analyzed. Median follow up duration was 756 (range, 419-1355). The primary end point was disease-free survival.RESULTS: Twenty-five of 163 patients (15.3%) had recurrences. The median SUVmax values of the recurrence and no-recurrence groups were 8.9 (range, 5-24) and 8.2 (range, 0-23, P = 0.998). Receiver operating characteristic (ROC) curve analysis showed no significant association between SUVmax and recurrence (area under the curve = 0.5, P = 0.998, 95% CI: 0.389-0.611). Because a statistically significant value was not found, SUVmax was dichotomized at its median of 8.6. The disease-free survival curve was analyzed using the median SUVmax (8.6) as the cut off. Univariate and multivariate analysis did not provide evidence that disease-free survival rates for the subgroups defined by the median SUVmax were significantly different (P = 0.52, P = 0.25). CONCLUSION:Our study suggests that the high FDG uptake of primary mass in resectable colorectal cancer doesn't have a significant relationship with tumor recurrence and disease-free survival.

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High FDG uptake in PET/CT predicts worse prognosis in patients with metastatic gastric adenocarcinoma

Abstract: High FDG uptake of the primary tumor in patients with metastatic gastric adenocarcinoma is associated with poor overall survival. Assessment of tumor FDG uptake has limited value for prediction of chemotherapeutic response, but provides useful information regarding prognosis.

Cited by 55 publications

References 27 publications

The Predictive and Prognostic Value of Early Metabolic Response Assessed by Positron Emission Tomography in Advanced Gastric Cancer Treated with Chemotherapy

The Predictive and Prognostic Value of Early Metabolic Response Assessed by Positron Emission Tomography in Advanced Gastric Cancer Treated with Chemotherapy

Gastric cancers with microsatellite instability exhibit high fluorodeoxyglucose uptake on positron emission tomography

Prognostic value of 18-fluorodeoxyglucose positron emission tomography-computed tomography in resectable colorectal cancer

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