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European Radiology
Erschienen in: European Radiology 10/2021

25.03.2021 | Oncology

Added value of [18F]FDG PET/MRI over MDCT alone in the staging of recurrent gastric cancer

verfasst von: Ieun Yoon, Jae Seok Bae, Jeongin Yoo, Dong Ho Lee, Se Hyung Kim

Erschienen in: European Radiology | Ausgabe 10/2021

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Abstract

Objectives

To investigate whether 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) can improve the diagnostic performance of TNM staging and help in making an accurate decision regarding resectability in patients with recurrent gastric cancer compared to multi-detector computed tomography (MDCT).

Methods

Fifty patients with histologically (n = 31) or clinically (n = 19) confirmed recurrent gastric cancer underwent both MDCT and [18F]FDG PET/MRI. Two radiologists independently assessed TNM staging using MDCT with and without [18F]FDG PET/MRI and scored resectability using a 5-point confidence scale. Diagnostic performance as assessed by radiologists was compared using McNemar’s test and receiver operating characteristic curve analysis.

Results

Of the 50 patients, pathologic T and N staging was available in seven and six patients, respectively. Diagnostic accuracies for T and N staging were not significantly different between MDCT with and without [18F]FDG PET/MRI for both reviewers (p > 0.05). However, for M staging, diagnostic accuracy was significantly improved when 18F-FDG PET/MRI was added to MDCT alone (68.0% [34/50] to 90.0% [45/50] for reviewer 1 [p = 0.001] and 66.0% [33/50] to 96.0% [46/50] for reviewer 2 [p < 0.001]). Regarding the resectability of recurrent gastric cancers, the addition of [18F]FDG PET/MRI increased the area under the curve values for both reviewers (from 0.860 to 0.989 for reviewer 1 and from 0.778 to 0.898 for reviewer 2), with a statistical significance for reviewer 2 (p = 0.002).

Conclusion

Compared to MDCT alone, MDCT plus [18F]FDG PET/MRI can improve the diagnostic accuracy for evaluating preoperative M staging as well as resectability for recurrent gastric cancers.

Key Points

• [ 18 F]FDG PET/MRI can improve diagnostic accuracy for preoperative M staging in patients with recurrent gastric cancers.
• [ 18 F]FDG PET/MRI can improve diagnostic accuracy for determining resectability in patients with recurrent gastric cancers.
• [ 18 F]FDG PET/MRI can provide critical clues for management options for recurrent gastric cancers.
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Metadaten
Titel
Added value of [18F]FDG PET/MRI over MDCT alone in the staging of recurrent gastric cancer
verfasst von
Ieun Yoon
Jae Seok Bae
Jeongin Yoo
Dong Ho Lee
Se Hyung Kim
Publikationsdatum
25.03.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-07839-4

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