Skip to main content

Advertisement

SpringerLink
Log in

Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer

  • Original Article
  • Published:
Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to characterize the patterns of fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography/computed tomography (FDG PET/CT) at the anastomotic site of gastroduodenostomy after distal subtotal gastrectomy in patients with gastric cancer.

Methods

From May 2007 to May 2010, two or more follow-up measurements using FDG PET/CT scans were done for 19 patients (11 men, 8 women; mean age, 62.0 ± 10.3 years) who underwent distal subtotal gastrectomy with gastroduodenostomy between February 2006 and March 2008 for detecting gastric cancer recurrence at our medical center. The FDG PET/CT images were retrospectively reviewed. Patients with local recurrence, regional nodal metastasis or distant metastasis on follow-up studies were excluded. CT and endoscopy were done within 1 month before or after the FDG PET/CT scan. Eight patients had two follow-ups of FDG PET/CT, and 11 patients had three follow-ups. The mean interval between surgery and the first follow-up FDG PET/CT was 12.9 ± 0.8 months (n = 19); between the first and second it was 12.3 ± 1.0 months (n = 19); between the second and third it was 11.6 ± 0.7 months (n = 11). The F-18 FDG uptakes at the anastomotic site and fundus in the remnant stomach were measured by maximum standardized uptake value (SUVmax) using a region of interest technique.

Results

The SUVmax at the anastomotic site was significantly higher than that of the fundus on all series of first, second and third follow-up studies (3.3 ± 1.1 vs. 2.1 ± 0.7, p < 0.001: 3.1 ± 0.9 vs. 2.2 ± 0.7, p = 0.001: 3.0 ± 0.6 vs. 2.1 ± 0.7, p = 0.006, respectively). The SUVmax for the anastomotic site and fundus, and SUVmax ratio for the anastomotic site over the fundus were not significantly different throughout the series.

Conclusion

The SUVmax at the anastomotic site is significantly higher than that of the fundus and does not decrease significantly over time. Therefore, the local recurrence of gastric cancer after surgery could not be definitely differentiated from physiologic uptake or postoperative inflammatory change.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Sim SH, Kim YJ, Oh DY, Lee SH, Kim DW, Kang WJ, et al. The role of PET/CT in detection of gastric cancer recurrence. BMC Cancer. 2009;9:73.

    Article  PubMed  Google Scholar 

  2. De Potter T, Flamen P, Van Cutsem E, Penninckx F, Filez L, Bormans G, et al. Whole-body PET with FDG for the diagnosis of recurrent gastric cancer. Eur J Nucl Med Mol Imaging. 2002;29(4):525–9.

    Article  PubMed  Google Scholar 

  3. Yoshioka T, Yamaguchi K, Kubota K, Saginoya T, Yamazaki T, Ido T, et al. Evaluation of 18F-FDG PET in patients with advanced, metastatic, or recurrent gastric cancer. J Nucl Med. 2003;44(5):690–9.

    PubMed  CAS  Google Scholar 

  4. Eom BW, Ryu KW, Lee JH, Choi IJ, Kook MC, Cho SJ, et al. Oncologic effectiveness of regular follow-up to detect recurrence after curative resection of gastric cancer. Ann Surg Oncol. 2011;18(2):358–64.

    Article  PubMed  Google Scholar 

  5. Yoo CH, Noh SH, Shin DW, Choi SH, Min JS. Recurrence following curative resection for gastric carcinoma. Br J Surg. 2000;87(2):236–42.

    Article  PubMed  CAS  Google Scholar 

  6. Sun L, Su XH, Guan YS, Pan WM, Luo ZM, Wei JH, et al. Clinical role of 18F-fluorodeoxyglucose positron emission tomography/ computed tomography in post-operative follow up of gastric cancer: initial results. World J Gastroenterol. 2008;14(29):4627–32.

    Article  PubMed  Google Scholar 

  7. Mochiki E, Kuwano H, Katoh H, Asao T, Oriuchi N, Endo K. Evaluation of 18F-2-deoxy-2-fluoro-D-glucose positron emission tomography for gastric cancer. World J Surg. 2004;28(3):247–53.

    Article  PubMed  Google Scholar 

  8. Yun MJ, Choi HS, Yoo E, Bong JK, Ryu YH, Lee JD. The role of gastric distention in differentiating recurrent tumor from physiologic uptake in the remnant stomach on 18F-FDG PET. J Nucl Med. 2005;46(6):953–7.

    PubMed  Google Scholar 

  9. Fuchs CS, Mayer R. Gastric carcinoma. N Engl J Med. 1995;333(1):32–41.

    Article  PubMed  CAS  Google Scholar 

  10. Akoh JA, Macintyre IM. Improving survival in gastric cancer: review of 5-year survival rates in English language publications from 1970. Br J Surg. 1992;79(4):293–9.

    Article  PubMed  CAS  Google Scholar 

  11. Whiting J, Sano T, Saka M, Fukagawa T, Katai H, Sasako M. Follow-up of gastric cancer: a review. Gastric Cancer. 2006;9(2):74–81.

    Article  PubMed  Google Scholar 

  12. Bilici A, Ustaalioglu BB, Seker M, Kefeli U, Canpolat N, Tekinsoy B, et al. The role of (18)F-FDG PET/CT in the assessment of suspected recurrent gastric cancer after initial surgical resection: can the results of FDG PET/CT influence patients' treatment decision making? Eur J Nucl Med Mol Imaging. 2011;38(1):64–73.

    Article  PubMed  Google Scholar 

  13. Park JH, Lee JH, Rhee PL, Kim JJ, Rhee JC, Kim S, et al. Endoscopic screening for remnant gastric cancer: points to be considered. Gut Liver. 2007;1(1):22–6.

    Article  PubMed  Google Scholar 

  14. Kubo M, Sasako M, Gotoda T, Ono H, Fujishiro M, Saito D, et al. Endoscopic evaluation of the remnant stomach after gastrectomy: proposal for a new classification. Gastric Cancer. 2002;5(2):83–9.

    Article  PubMed  Google Scholar 

  15. Lee SY, Lee JH, Hwang NC, Kim YH, Rhee PL, Kim JJ, et al. The role of follow-up endoscopy after total gastrectomy for gastric cancer. Eur J Surg Oncol. 2005;31(3):265–9.

    Article  PubMed  Google Scholar 

  16. Johannesson KA, Hammar E, Staël von Holstein C. Mucosal changes in the gastric remnant: long-term effects of bile reflux diversion and Helicobacter pylori infection. Eur J Gastroenterol Hepatol. 2003;15(1):35–40.

    Article  PubMed  Google Scholar 

  17. Nunobe S, Okaro A, Sasako M, Saka M, Fukagawa T, Katai H, et al. Billroth 1 versus Roux-en-Y reconstructions: a quality-of-life survey at 5 years. Int J Clin Oncol. 2007;12(6):433–9.

    Article  PubMed  Google Scholar 

  18. Lim JS, Yun MJ, Kim MJ, Hyung WJ, Park MS, Choi JY, et al. CT and PET in stomach cancer: preoperative staging and monitoring of response to therapy. Radiographics. 2006;26(1):143–56.

    Article  PubMed  Google Scholar 

  19. Park MJ, Lee WJ, Lim HK, Park KW, Choi JY, Kim BT. Detecting recurrence of gastric cancer: the value of FDG PET/CT. Abdom Imaging. 2009;34(4):441–7.

    Article  PubMed  Google Scholar 

  20. Antoch G, Kanja J, Bauer S, Kuehl H, Renzing-Koehler K, Schuette J, et al. Comparison of PET, CT, and dual-modality PET/CT imaging for monitoring of imatinib (STI571) therapy in patients with gastrointestinal stromal tumors. J Nucl Med. 2004;45(3):357–65.

    PubMed  CAS  Google Scholar 

  21. Nakamoto Y, Togashi K, Kaneta T, Fukuda H, Nakajima K, Kitajima K, et al. Clinical value of whole-body FDG-PET for recurrent gastric cancer: a multicenter study. Jpn J Clin Oncol. 2009;39(5):297–302.

    Article  PubMed  Google Scholar 

  22. Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics. 1999;19(1):61–77. quiz150-1.

    PubMed  CAS  Google Scholar 

  23. Takahashi H, Ukawa K, Ohkawa N, Kato K, Hayashi Y, Yoshimoto K, et al. Significance of 18F-2-deoxy-2-fluoro-glucose accumulation in the stomach on positron emission tomography. Ann Nucl Med. 2009;23(4):391–7.

    Article  PubMed  Google Scholar 

  24. Lin CY, Liu CS, Ding HJ, Sun SS, Yen KY, Hsieh TC, et al. Positive correlation between standardized uptake values of FDG uptake in the stomach and the value of the C-13 urea breath test. Clin Nucl Med. 2006;31(12):792–4.

    Article  PubMed  Google Scholar 

  25. Jadvar H, Tatlidil R, Garcia AA, Conti PS. Evaluation of recurrent gastric malignancy with [F-18]-FDG positron emission tomography. Clin Radiol. 2003;58(3):215–21.

    Article  PubMed  CAS  Google Scholar 

  26. Wang X, Koch S. Positron emission tomography/computed tomography potential pitfalls and artifacts. Curr Probl Diagn Radiol. 2009;38(4):156–69.

    Article  PubMed  Google Scholar 

  27. Balink H, Collins J, Bruyn GA, Gemmel F. F-18 FDG PET/CT in the diagnosis of fever of unknown origin. Clin Nucl Med. 2009;34(11):862–8.

    Article  PubMed  Google Scholar 

  28. Imperiale A, Federici L, Lefebvre N, Braun JJ, Pfumio F, Kessler R. F-18 FDG PET/CT as a valuable imaging tool for assessing treatment efficacy in inflammatory and infectious diseases. Clin Nucl Med. 2010;35(2):86–90.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Keimyung University, School of Medicine, #194, Dongsan-Dong, Jung-Gu, Daegu, Korea

    Byung Wook Choi, Seok Kil Zeon, Sung Hun Kim, Il Jo, Hae Won Kim & Kyoung Sook Won

Authors
  1. Byung Wook Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seok Kil Zeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sung Hun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Il Jo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hae Won Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kyoung Sook Won
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seok Kil Zeon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Choi, B.W., Zeon, S.K., Kim, S.H. et al. Significance of SUV on Follow-up F-18 FDG PET at the Anastomotic Site of Gastroduodenostomy after Distal Subtotal Gastrectomy in Patients with Gastric Cancer. Nucl Med Mol Imaging 45, 285–290 (2011). https://doi.org/10.1007/s13139-011-0105-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13139-011-0105-9

Keywords

Search

Navigation