Yonsei Med J.  2011 Jan;52(1):81-88. 10.3349/ymj.2011.52.1.81.

The Role of 18F-FDG PET/CT in the Evaluation of Gastric Cancer Recurrence after Curative Gastrectomy

  • 1Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea. sphong@cha.ac.kr
  • 2Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.


18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans are frequently performed for the screening or staging of malignant tumors. This study aimed to assess the usefulness of 18F-FDG PET/CT in detection of gastric cancer recurrence after curative gastrectomy.
Eighty nine patients who had undergone curative gastrectomy due to gastric cancer and had 18F-FDG PET/CT and contrast CT scans within 2 weeks for surveillance in asymptomatic patients (n = 11) or to clarify suspected recurrence (n = 78) were consecutively collected and retrospectively analyzed. They had clinical follow-up for at least 12 months after PET/CT and CT scans.
Fifteen of the 89 patients (16.9%) were diagnosed with recurrent gastric cancer in 21 organs. Forty one organs showed an increase in FDG uptake, and only 9 of these organs were diagnosed with recurrent gastric cancer by 18F-FDG PET/CT. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the 18F-FDG PET/CT were 42.9%, 59.7%, 29.3%, 78.2%, and 57.3%, respectively. On the CT scan, 18 of 21 recurrent gastric cancers were detected, and 7 cases were in agreement with the 18F-FDG PET/CT. The sensitivity and specificity of the CT scan were 85.8% and 87.3%, respectively, which are superior to the 18F-FDG PET/CT. When we diagnosed a recurrence based on either 18F-FDG PET/CT or CT scans, the sensitivity increased to 95.2% and the specificity decreased to 45.6%, when compared with the contrast CT scan alone.
18F-FDG PET/CT is an insufficient diagnostic method in detection of recurrence after curative gastrectomy, and even less accurate than contrast CT scan alone.


Gastric cancer; recurrence; 18F-FDG PET/CT scan; contrast CT scan

MeSH Terms

Aged, 80 and over
Fluorodeoxyglucose F18/*diagnostic use
Middle Aged
Neoplasm Recurrence, Local/*diagnosis
Positron-Emission Tomography/*methods
Stomach Neoplasms/*diagnosis/*surgery
Tomography, X-Ray Computed/*methods


  • Fig. 1 A case of recurring gastric cancer detected by FDG-uptake on PET/CT. This 57 year-old man showed no suspicion of recurrence on the abdomino-pelvic CT scan. However, on the whole body PET/CT scan, there was a high FDG-uptake on the left supraclavicular lymph node. This lesion was confirmed as distant nodal metastasis by biopsy. FDG, fluorodeoxyglucose; PET, positron emission.

  • Fig. 2 A case of recurrent gastric cancer detected by CT scan but showing no FDG-uptake on PET/CT. (A) This 52 year-old woman showed peritoneal carcinomatosis and right ovarian enlargement with septated cystic mass on CT scan. (B) However, on the 18F-FDG PET/CT scan, there was no abnormal FDG-uptake. The recurrence was confirmed by peritoneal fluid cytology. FDG, fluorodeoxyglucose; PET, positron emission.

Cited by  2 articles

Imaging of Gastric Cancer Metabolism Using 18 F-FDG PET/CT
Mijin Yun
J Gastric Cancer. 2014;14(1):1-6.    doi: 10.5230/jgc.2014.14.1.1.

Diagnostic performance of F-18 FDG PET or PET/CT for detection of recurrent gastric cancer: a systematic review and meta-analysis
Chang In Choi, Jae Kyun Park, Tae Yong Jeon, Dae-Hwan Kim
J Yeungnam Med Sci. 2023;40(Suppl):S37-S46.    doi: 10.12701/jyms.2023.00220.


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