Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2016; 22(34): 7787-7796
Published online Sep 14, 2016. doi: 10.3748/wjg.v22.i34.7787
18F-fluorodeoxyglucose positron emission tomography/computed tomography comparison of gastric lymphoma and gastric carcinoma
Xiao-Feng Li, Qiang Fu, You-Wen Dong, Jian-Jing Liu, Xiu-Yu Song, Dong Dai, Cong Zuo, Wen-Gui Xu
Xiao-Feng Li, Qiang Fu, You-Wen Dong, Jian-Jing Liu, Xiu-Yu Song, Dong Dai, Cong Zuo, Wen-Gui Xu, Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
Xiao-Feng Li, Qiang Fu, You-Wen Dong, Jian-Jing Liu, Xiu-Yu Song, Dong Dai, Cong Zuo, Wen-Gui Xu, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
Author contributions: Li XF designed the study, analyzed the data and wrote the paper; Fu Q, Dong YW and Zuo C collected the data; Liu JJ, Song XY and Dai D performed the data analysis; Xu WG designed the study, and revised the paper; all authors have read and approved the final version to be published.
Supported by the National Natural Science Foundation of China, No. 81501984 and No. 81601377; Tianjin Municipal Bureau of Health Science and Technology, No. 2015KZ084 and No. 2013KZ088; and Tianjin Medical University Science, No. 2013KYQ07.
Institutional review board statement: The study was reviewed and approved by the Tianjin Medical University Cancer Institute and Hospital Institutional Review Board.
Informed consent statement: Due to the retrospective nature of the study, patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to receive examination of 18F-fluorodeoxyglucose positron emission tomography/computed tomography by written informed consent.
Conflict-of-interest statement: The authors declare no conflict of interest related to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wen-Gui Xu, MD, Professor, Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Huan-Hu-Xi Road, Ti-Yuan-Bei, Hexi District, Tianjin 300060, China. wxu06@tmu.edu.cn
Telephone: +86-22-23340123-5923 Fax: +86-22-23537796
Received: April 19, 2016
Peer-review started: April 21, 2016
First decision: May 12, 2016
Revised: May 20, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: September 14, 2016
Abstract
AIM

To compare 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) features in gastric lymphoma and gastric carcinoma.

METHODS

Patients with newly diagnosed gastric lymphoma or gastric carcinoma who underwent 18F-FDG PET/CT prior to treatment were included in this study. We reviewed and analyzed the PET/CT features of gastric wall lesions, including FDG avidity, pattern (focal/diffuse), and intensity [maximal standard uptake value: (SUVmax)]. The correlation of SUVmax with gastric clinicopathological variables was investigated by χ2 test, and receiver-operating characteristic (ROC) curve analysis was performed to determine the differential diagnostic value of SUVmax-associated parameters in gastric lymphoma and gastric carcinoma.

RESULTS

Fifty-two patients with gastric lymphoma and 73 with gastric carcinoma were included in this study. Abnormal gastric FDG accumulation was found in 49 patients (94.23%) with gastric lymphoma and 65 patients (89.04%) with gastric carcinoma. Gastric lymphoma patients predominantly presented with type I and type II lesions, whereas gastric carcinoma patients mainly had type III lesions. The SUVmax (13.39 ± 9.24 vs 8.35 ± 5.80, P < 0.001) and SUVmax/THKmax (maximal thickness) (7.96 ± 4.02 vs 4.88 ± 3.32, P < 0.001) were both higher in patients with gastric lymphoma compared with gastric carcinoma. ROC curve analysis suggested a better performance of SUVmax/THKmax in the evaluation of gastric lesions between gastric lymphoma and gastric carcinoma in comparison with that of SUVmax alone.

CONCLUSION

PET/CT features differ between gastric lymphoma and carcinoma, which can improve PET/CT evaluation of gastric wall lesions and help differentiate gastric lymphoma from gastric carcinoma.

Keywords: Gastric lymphomas, Gastric carcinomas, 18F-fluorodeoxyglucose positron emission tomography/computed tomography, Maximal standard uptake value, Maximal thickness, Differential diagnosis

Core tip:18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) feature in gastric lymphomas compared to that in gastric carcinomas were investigated. Gastric lymphoma patients predominantly presented with type I and type II lesions, whereas gastric carcinoma patients mainly with type III lesions. The SUVmax and SUVmax/THKmax were both higher in patients with gastric lymphomas compared to that in patients with gastric carcinomas. A ROC curve analysis suggested a better performance of SUVmax/THKmax in the evaluation of gastric lesions in comparison with that of SUVmax alone. The differences existed in the PET/CT feature could improve the PET/CT evaluation of gastric lesions and contribute to the identification of gastric lymphomas from gastric carcinomas.