J Korean Soc Radiol.  2015 Jan;72(1):11-19. 10.3348/jksr.2015.72.1.11.

Comparison of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography, Hydro-Stomach Computed Tomography, and Their Combination for Detecting Primary Gastric Cancer

• Jang HY
• Chung WS
• Song ER
• Kim JS

• KMID: 1823929
• DOI: http://doi.org/10.3348/jksr.2015.72.1.11

Abstract

PURPOSE
To retrospectively compare the diagnostic accuracy for detecting primary gastric cancer on positron emission tomography/computed tomography (PET/CT) and hydro-stomach CT (S-CT) and determine whether the combination of the two techniques improves diagnostic performance.
MATERIALS AND METHODS
A total of 253 patients with pathologically proven primary gastric cancer underwent PET/CT and S-CT for the preoperative evaluation. Two radiologists independently reviewed the three sets (PET/CT set, S-CT set, and the combined set) of PET/CT and S-CT in a random order. They graded the likelihood for the presence of primary gastric cancer based on a 4-point scale. The diagnostic accuracy of the PET/CT set, the S-CT set, and the combined set were determined by the area under the alternative-free receiver operating characteristic curve, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.
RESULTS
Diagnostic accuracy, sensitivity, and NPV for detecting all gastric cancers and early gastric cancers (EGCs) were significantly higher with the combined set than those with the PET/CT and S-CT sets. Specificity and PPV were significantly higher with the PET/CT set than those with the combined and S-CT set for detecting all gastric cancers and EGCs.
CONCLUSION
The combination of PET/CT and S-CT is more accurate than S-CT alone, particularly for detecting EGCs.

MeSH Terms

Electrons*
Humans
Positron-Emission Tomography and Computed Tomography
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Stomach Neoplasms*

Figure

• 

  Fig. 1 A 69-year-old male with a poorly differentiated adenocarcinoma of the lesser curvature side of stomach antrum (T2 stage). A, B. Axial and coronal CT scan show ulcerofungating with submucosal enhancing lesion (black and white arrows) in the stomach antrum. C, D. Positron emission tomography (PET) and PET/CT fusion image show thickened stomach wall with focal strong fluorodeoxyglucose uptake lesion (black and white arrows) in the stomach antrum. The mean maximum standardized uptake values were both 4.2.

• 

  Fig. 2 A 75-year-old male with a moderately differentiated adenocarcinoma of the lesser curvature side of stomach antrum (T1a stage). A, B. Axial and coronal CT scan show no detectable lesion in the stomach. C, D. Positron emission tomography (PET) and PET/CT fusion image show focal fluorodeoxyglucose uptake lesion (black and white arrow) in lesser curvature side of stomach antrum. The mean maximum standardized uptake values were both 3.0.

• 

  Fig. 3 A 55-year-old male with a moderately-differentiated adenocarcinoma of the posterior wall of stomach body (T3). A, B. Axial and coronal CT scan show focal wall thickening and enhancement in the lower body of the stomach, near the angle area (white arrow). C, D. Positron emission tomography (PET) and PET/CT fusion image obtained at the same level show no discernible fluorodeoxyglucose uptake in the stomach (black arrow).

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