Evaluation of recurrence in gastric carcinoma: Comparison of contrast-enhanced computed tomography and positron emission tomography/computed tomography
World Journal of Gastroenterology Sep 27, 2017
Kim JH, et al. - The physicians aimed to compare the value of contrast-enhanced abdominal computed tomography (CT) and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the detection of gastric carcinoma recurrence. For detecting peritoneal carcinomatosis and pathologic type of adenocarcinoma, contrast-enhanced CT was superior to PET/CT.
Methods- Data was retrospectively examined from 2475 patients who underwent both contrast-enhanced abdominal CT and FDG PET/CT for the surveillance of gastric carcinoma curative resection.
- Between their CT and PET/CT scans, patients had an interval of less than 1 mo.
- The physicians enrolled 60 patients who had recurrence.
- By using simple random sampling, they selected 60 patients, among 1896 patients who did not have a recurrence.
- By 2 reviewers blinded to all clinical and pathologic information except curative resection due to gastric carcinoma, all CT and PET/CT images were reviewed retrospectively.
- Compared with the control group, the pathological stage of the recurrence group was statistically significantly higher (P < 0.001).
- There were 79 recurrent lesions in the 60 patients who had recurrence.
- In this study, 44 patients had only 1 location of recurrence, 13 patients had 2 locations, and 3 patients had 3.
- No statistically significant differences existed between the two modalities in the detection of patient-based overall recurrence (P = 0.096).
- However, compared to PET/CT, CT had a statistically significantly higher sensitivity (96% vs 50%, P = 0.001) for peritoneal carcinomatosis.
- The most common type of gastric carcinoma was adenocarcinoma.
- CT also had a statistically significantly higher sensitivity compared to PET/CT (98% vs 80%, P = 0.035) on the pathology-based analysis.
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