Cancer Res Treat.  2009 Jun;41(2):100-103.

Hepatic Metastases of Gastric Adenocarcinoma Showing Metabolic Remission on FDG-PET Despite an Increase in Size on CT

• Yoon SY
• Kim SY
• Cho YH
• Chung HW
• So Y
• Lee HM

Abstract

We report a gastric adenocarcinoma patient with liver metastases. The metastases showed progression on computed tomography (CT), but this was not true progression in terms of metabolic activity according to (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET). Discordance between size criteria and metabolic criteria has been reported in liver gastrointestinal stromal tumors, hepatomas, and renal cell carcinomas after dramatic responses with targeted therapies such as imatinib, sorafenib, and sunitinib (1-6). However, this discordance has been rarely reported in liver metastases of gastric adenocarcinoma when treated with conventional chemotherapy.

Keyword

Hepatic metastasis; Stomach neoplasms; Metabolic remission; Positron-emission tomography

MeSH Terms

Adenocarcinoma
Benzamides
Carcinoma, Hepatocellular
Carcinoma, Renal Cell
Gastrointestinal Stromal Tumors
Humans
Indoles
Liver
Neoplasm Metastasis
Niacinamide
Phenylurea Compounds
Piperazines
Positron-Emission Tomography
Pyrimidines
Pyrroles
Stomach Neoplasms
Imatinib Mesylate
Benzamides
Indoles
Niacinamide
Phenylurea Compounds
Piperazines
Pyrimidines
Pyrroles

Figure

• 

  Fig. 1 (A, A') Baseline CT and FDG-PET before chemotherapy. (B, B') CT and FDG-PET after 6 cycles of chemotherapy. After 6 cycles of chemotherapy, the sizes of the metastatic liver masses definitively increased 20% above the original tumor sizes according to CT. This patient showed disease progression according to RECIST criteria. However, the hepatic masses also turned cystic and necrotic compared to the original masses. In addition to that finding on CT, there was no metabolic activity in the liver masses on FDG-PET after chemotherapy.

• 

  Fig. 2 (A, A') Baseline CT and FDG-PET before chemotherapy. (B, B') CT and FDG-PET after 6 cycles of chemotherapy. The maximum SUV of the lymph nodes decreased from 7.6 into 2.4. Taken together, the patient showed metabolic PR according to maximum SUV on FDG-PET.

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