Japanese Gastric Cancer Association Task Force for Research Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature

Abstract

Since April 2010, the Japanese Public Health Insurance System has covered the costs incurred for performing 18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) imaging for patients with advanced gastric cancer. The aim of this review was to evaluate the clinical impact of PET for patients with gastric cancer. A systematic literature search was performed in PubMed/MEDLINE using the keywords ''gastric cancer'' and ''PET'' to search for relevant articles published from January 2000 to September 2010. The clinical impact of selected articles was assessed by the authors to evaluate the following: (a) tumor staging, (b) diagnosis for recurrent disease, (c) evaluation of treatment response, and (d) screening for gastric cancer. FDG uptake increases in papillary adenocarcinoma, tubular adenocarcinoma, and solid-type poorly differentiated adenocarcinoma. This uptake is also associated with glucose transporter 1 expression. The sensitivity and specificity of FDG-PET for metastatic lymph node detection were 21-40% and 89-100%, respectively. The sensitivity and specificity for distant metastasis detection were 35-74% and 74-99%, respectively. Treatment response can be detectable at an earlier stage by PET than by computed tomography (CT), because FDG uptake by cancer cells decreases according to the treatment response. In summary, although PET has limitations such as frequent false-negative cases in signetring cell carcinoma and non-solid type poorly differentiated carcinoma, it can contribute to the selection of a more appropriate treatment modality by detecting distant metastases and treatment response.

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

“…This rate of visible tumor 18 F-FDG uptake is well within the 34%-94% range of sensitivity reported for PET/CT in detecting advanced gastric cancer (20). The wide range of reported sensitivity indicates that multiple factors influence the magnitude of gastric tumor 18 F-FDG uptake.…”

One-pot synthesis of dextran-coated iron oxide nanoclusters for real-time regional lymph node mapping

“…However, because of the limitations of the equipment, intraoperative mapping could not be performed with these imaging methods, possibly leading to inadequate removal of metastatic LNs or excessive LN dissection. [6][7][8][9][10] In addition, certain dyes or isotopes have been used primarily to provide intraoperative visual guidance in mapping regional LNs, but these materials have no tumor specificity, which could cause a high false-negative rate for metastatic LNs.…”

The Role Of Diffusion-Weighted Mr Imaging And Adc Values In The Diagnosis Of Gastric Tumors

“…To mention in a few words about the comparative role of PET/CT in the evaluation of gastric cancer, the sensitivity and accuracy of PET/CT were found to be inferior to those of contrast enhanced CT in the diagnosis of regional lymph node metastases, while its sensitivity, accuracy, positive predictive value, and negative predictive value were superior in the diagnosis of distant metastases (27).…”