<sup>18</sup>F-Fluorodeoxyglucose positron emission tomography/computed tomography comparison of gastric lymphoma and gastric carcinoma

Li, Xiaofeng; Fu, Qiang; Dong, You-Wen; Liu, Jianjing; Song, Xiaomin; Dong, Diansheng; Zuo, Cong; Xu, Wengui

doi:10.3748/wjg.v22.i34.7787

Cited by 15 publications

(13 citation statements)

References 36 publications

(55 reference statements)

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“…[ 14 – 16 ] Semi-quantitatively, the standard uptake value (SUV) and its derivatives, which correlate to the degree of FDG uptake in tissues, have been demonstrated to help differentiate gastric cancer from gastric lymphoma. [ 17 , 18 ] Nonetheless, FDG uptake has a wide range in both gastric cancer and gastric lymphoma, [ 15 , 17 , 19 ] which is partially due to the differences between pathological subtypes. Therefore, the differential diagnostic accuracy based on only SUV and its derivatives is moderate.…”

Section: Introductionmentioning

confidence: 99%

Differentiating gastric cancer and gastric lymphoma using texture analysis (TA) of positron emission tomography (PET)

Sun

Wang

et al. 2020

Chinese Medical Journal

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Background: Texture analysis (TA) can quantify intra-tumor heterogeneity using standard medical images. The present study aimed to assess the application of positron emission tomography (PET) TA in the differential diagnosis of gastric cancer and gastric lymphoma. Methods: The pre-treatment PET images of 79 patients (45 gastric cancer, 34 gastric lymphoma) between January 2013 and February 2018 were retrospectively reviewed. Standard uptake values (SUVs), first-order texture features, and second-order texture features of the grey-level co-occurrence matrix (GLCM) were analyzed. The differences in features among different groups were analyzed by the two-way Mann-Whitney test, and receiver operating characteristic (ROC) analysis was used to estimate the diagnostic efficacy. Results: Inertia GLCM was significantly lower in gastric cancer than that in gastric lymphoma (4975.61 vs. 11,425.30, z = −3.238, P = 0.001), and it was found to be the most discriminating texture feature in differentiating gastric lymphoma and gastric cancer. The area under the curve (AUC) of inertia GLCM was higher than the AUCs of SUVmax and SUVmean (0.714 vs. 0.649 and 0.666, respectively). SUVmax and SUVmean were significantly lower in low-grade gastric lymphoma than those in high grade gastric lymphoma (3.30 vs. 11.80, 2.40 vs. 7.50, z = −2.792 and −3.007, P = 0.005 and 0.003, respectively). SUVs and first-order grey-level intensity features were not significantly different between low-grade gastric lymphoma and gastric cancer. Entropy GLCM12 was significantly lower in low-grade gastric lymphoma than that in gastric cancer (6.95 vs. 9.14, z = −2.542, P = 0.011) and had an AUC of 0.770 in the ROC analysis of differentiating low-grade gastric lymphoma and gastric cancer. Conclusions: Inertia GLCM and entropy GLCM were the most discriminating features in differentiating gastric lymphoma from gastric cancer and low-grade gastric lymphoma from gastric cancer, respectively. PET TA can improve the differential diagnosis of gastric neoplasms, especially in tumors with similar degrees of fluorodeoxyglucose uptake.

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Section: Introductionmentioning

confidence: 99%

Differentiating gastric cancer and gastric lymphoma using texture analysis (TA) of positron emission tomography (PET)

Sun

Wang

et al. 2020

Chinese Medical Journal

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“…Sun Gaofeng et al [25] studied the PET/CT results of 43 patients with gastric cancer and patients with primary gastric lymphoma and found that there was a difference in SUVmax between them, and the P < 0.05. Similarly, Li XF [26] et al retrospectively analysed 73 cases of gastric cancer and 52 cases of gastric lymphoma, and found that compared with gastric cancer, the results of PET/CT examination of gastric lymphoma were different, and higher SUVmax suggested that gastric lymphoma was more likely. The above results are consistent with the results of the present study.…”

Section: Discussionmentioning

confidence: 99%

Value of Maximum Standard Uptake Value as a Positron Emission Tomography/Computed Tomography Index in the Diagnosis and Prognosis of Patients with Gastric Cancer

Wang¹,

Wang²,

Zhao³

et al. 2021

Preprint

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Background: To study the application value of standard uptake value (SUVmax), a positron emission tomography/computed tomography (PET/CT) index in the diagnosis and evaluation of the prognosis of patients with gastric cancer who have not received any treatment. Methods: A retrospective analysis was made on the patients who were diagnosed to have gastric cancer at the General Hospital of Ningxia Medical University and received a PET/CT examination prior to treatment. According to different factors like sex, pathological stage, and survival time, the SUVmax in the results of 18F-labelled fluoro-2-deoxyglucose (18F-FDG) PET/CT examination was statistically compared and analysed. Results: A total of 110 newly diagnosed patients with gastric cancer were included in this study. Pathological results confirmed that there were 78 cases of gastric adenocarcinoma, 30 cases of primary gastric lymphoma and two cases of chronic atrophic gastritis. The difference between the primary gastric lymphoma group and gastric adenocarcinoma groups was statistically significant (t = 4.13, P < 0.05). In the postoperative pathological report of patients with gastric cancer, the SUVmax of stage I, stage II, stage III and stage IV were 2.89 ± 1.36, 14.09 ± 9.32, 7.36 ± 3.72, and 10.20 ± 1.91, respectively, the difference between each group was statistically significant (F = 16.10, P < 0.05).The univariate survival analysis showed that there was a significant difference in survival time between the low SUVmax and high SUVmax groups (X2 = 5.08, P < 0.05). Cox multivariate survival analysis showed that SUVmax was an independent factor affecting postoperative survival time of patients with gastric adenocarcinoma (P < 0.05). Compared with the low SUVmax group, patients in the high SUVmax group had a higher postoperative death risk than those in the low SUVmax group, hazard ration (HR) = 3.91 (95% confidence interval [CI]: 1.09-14.01). Conclusion: The index of SUVmax in PET/CT can provide a reliable semi-quantitative diagnostic value for pathological staging after gastric cancer surgery. Furthermore, SUVmax has an important reference value for the survival time of patients after gastric cancer surgery, which can better guide clinical treatment.

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“…The other 8 cases were misdiagnosed, half of these were localized in the gastrointestinal tract, putatively due to the speci c FDG uptake pattern of lymphoma in the gastrointestinal tract and this phenomenon is consistent with many previous studies that primary gastrointestinal lymphoma is a speci c type of digestive system tumor and its FDG uptake pattern is more likely to have low intake due to physiologic FDG activity in the gastrointestinal tract although variability in the degree of uptake occurred in various histologic subtypes of primary gastrointestinal lymphoma [17,20,21]. Hwang et al also con rmed that SUV max can be used as a prognostic marker for gastrointestinal lymphoma as it differed markedly from other gastrointestinal cancers and is one of the reliable differential diagnostic criteria [22,23]. However, the disease is insidious in onset and still easy to be misdiagnosed and missed in the examination; In this study, two of the misdiagnosed cases were misdiagnosed as in ammation, while the remaining were misdiagnosed as other tumors.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of 18F-PET/CT in Patients with Primary Lymphoma and the Prognostic Value of Maximum Standardized Uptake Value (SUVmax) in Diffuse Large B-Cell Lymphoma (DLBCL)

Zhu¹,

Nie²,

Chen³

et al. 2021

Preprint

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Background The diagnostic accuracy of 18F-PET/CT was assessed in patients with primary lymphoma and the clinical application value of SUVmax was determined. Results The diagnostic accuracy of a total of 97 patients with initial 18F-PET/CT scans between January 2015 and February 2020 were assessed, and the SUVmax was compared according to the different pathological subtypes. The relationship between SUVmax and immunophenotype, clinical characteristics, and genetic types were estimated. According to the pathological results, 10 cases were misdiagnosed by PET/CT, and the accuracy was about 90%. Statistical analysis did not reveal a significant difference between Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL) (p = 0.9071). Among NHL, the average SUVmax was statistically different between diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) (p = 0.0004), FL and natural killer/T-cell lymphoma (p = 0.0078), FL and peripheral T-cell lymphoma (PTCL) (p = 0.0117), DLBCL and mantle cell lymphoma (MCL) (p = 0.0294). In patients with DLBCL, SUVmax was correlated with the expression level of proliferation index Ki-67 (r = 0.33, p = 0.018), while average SUVmax shows no difference between various immunophenotype expression levels, ages, gender, skeletal invasion situations, clinical grade stages, international prognostic index (IPI) score, and different gene types (germinal center B cell-like (GCB) and non-GCB). Conclusions Although 18F-PET/CT had a marked diagnostic value in patients with primary lymphoma, some misdiagnosis was probable. The SUVmax is valuable in the differential diagnosis of different pathological types of NHL. Simultaneously, the SUVmax of patients with DLBCL correlated with Ki-67 might reflect the tumor invasiveness, thereby revealing a prognostic value.

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¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography comparison of gastric lymphoma and gastric carcinoma

Cited by 15 publications

References 36 publications

Differentiating gastric cancer and gastric lymphoma using texture analysis (TA) of positron emission tomography (PET)

Differentiating gastric cancer and gastric lymphoma using texture analysis (TA) of positron emission tomography (PET)

Value of Maximum Standard Uptake Value as a Positron Emission Tomography/Computed Tomography Index in the Diagnosis and Prognosis of Patients with Gastric Cancer

Diagnostic Value of 18F-PET/CT in Patients with Primary Lymphoma and the Prognostic Value of Maximum Standardized Uptake Value (SUVmax) in Diffuse Large B-Cell Lymphoma (DLBCL)

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18F-Fluorodeoxyglucose positron emission tomography/computed tomography comparison of gastric lymphoma and gastric carcinoma

Cited by 15 publications

References 36 publications

Differentiating gastric cancer and gastric lymphoma using texture analysis (TA) of positron emission tomography (PET)

Differentiating gastric cancer and gastric lymphoma using texture analysis (TA) of positron emission tomography (PET)

Value of Maximum Standard Uptake Value as a Positron Emission Tomography/Computed Tomography Index in the Diagnosis and Prognosis of Patients with Gastric Cancer

Diagnostic Value of 18F-PET/CT in Patients with Primary Lymphoma and the Prognostic Value of Maximum Standardized Uptake Value (SUVmax) in Diffuse Large B-Cell Lymphoma (DLBCL)

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¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography comparison of gastric lymphoma and gastric carcinoma