Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2017; 23(35): 6448-6456
Published online Sep 21, 2017. doi: 10.3748/wjg.v23.i35.6448
Evaluation of recurrence in gastric carcinoma: Comparison of contrast-enhanced computed tomography and positron emission tomography/computed tomography
Jong Hyeon Kim, Suk Hee Heo, Jin Woong Kim, Sang Soo Shin, Jung Jun Min, Seong Young Kwon, Yong Yeon Jeong, Heoung Keun Kang
Jong Hyeon Kim, Suk Hee Heo, Jin Woong Kim, Yong Yeon Jeong, Heoung Keun Kang, Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Jeonnam 519-763, South Korea
Sang Soo Shin, Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 501-757, South Korea
Jung Jun Min, Seong Young Kwon, Department of Nuclear Medicine, Chonnam National University Medical School, Chonnam National University Hwasun Hostpital, Jeonnam 519-763, South Korea
Author contributions: Kim JH and Jeong YY made substantial contributions to conception and design and analysis of data; Heo SS, Kim JW, Min JJ and Kwon SY contributed to acquisition of data; Kang HK and Shin SS reviewed the literature.
Institutional review board statement: This study was reviewed and approved by the Chonnam National University Hwasun Hospital Institutional Review Board.
Informed consent statement: Informed consent was waived because of the retrospective nature of the study and the analysis used anonymous clinical data.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest in publishing this article.
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: Yong-Yeon Jeong, MD, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeonnam 519-763, South Korea. yjeong@jnu.ac.kr
Telephone: +82-10-85573794 Fax: +82-62-2264380
Received: June 12, 2017
Peer-review started: June 13, 2017
First decision: July 17, 2017
Revised: July 26, 2017
Accepted: August 25, 2017
Article in press: August 25, 2017
Published online: September 21, 2017
Abstract
AIM

To compare the value of contrast-enhanced abdominal computed tomography (CT) and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for detecting gastric carcinoma recurrence.

METHODS

We retrospectively examined data from 2475 patients who underwent both contrast-enhanced abdominal CT and FDG PET/CT for the surveillance of gastric carcinoma curative resection. Patients had an interval of less than 1 mo between their CT and PET/CT scans. Sixty patients who had recurrence were enrolled. Among 1896 patients who did not have recurrence, 60 were selected by simple random sampling. All CT and PET/CT images were reviewed retrospectively by two reviewers blinded to all clinical and pathologic information except curative resection due to gastric carcinoma.

RESULTS

The pathological stage of the recurrence group was statistically significantly higher than that of the control group (P < 0.001). In the 60 patients who had recurrence, there were 79 recurrent lesions. Forty-four patients had only one location of recurrence, 13 patients had two locations, and 3 patients had three. In the detection of patient-based overall recurrence, no statistically significant differences existed between the two modalities (P = 0.096). However, for peritoneal carcinomatosis, CT had a statistically significantly higher sensitivity compared to PET/CT (96% vs 50%, P = 0.001). Adenocarcinoma was the most common type of gastric carcinoma. On the pathology-based analysis, CT also had a statistically significantly higher sensitivity compared to PET/CT (98% vs 80%, P = 0.035).

CONCLUSION

Contrast-enhanced CT was superior to PET/CT in the detection of peritoneal carcinomatosis and pathologic type of adenocarcinoma.

Keywords: Gastric carcinoma, Surgery, Contrast-enhanced abdominal computed tomography, Fluorodeoxyglucose positron emission tomograph/computed tomography, Surveillance, Recurrence

Core tip: Contrast-enhanced abdominal computed tomography (CT) and positron emission tomography/computed tomography (PET/CT) are commonly used imaging methods for surveillance of recurrence after gastric cancer surgery. However, the ideal method for early detection of gastric carcinoma recurrence remains controversial. In this study, we compared the value of contrast-enhanced abdominal CT and PET/CT for detecting the recurrence of gastric carcinoma after curative resection. We found that contrast-enhanced CT was superior to PET/CT in the detection of peritoneal carcinomatosis and pathologic type of adenocarcinoma.