Published in:
01-03-2020 | Computed Tomography | Hollow Organ GI
Role of 18F-FDG PET/CT in restaging and follow-up of patients with GIST
Published in: Abdominal Radiology | Issue 3/2020
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Purpose
Gastrointestinal stromal tumor (GIST) is a rare tumor with high risk of recurrence and poor prognosis in case of advanced GIST. The aim of this study was to evaluate the possible role of 18F-FDG PET/CT in restaging GIST.
Methods
Fifty-four patients (30 male) with histological proven GIST underwent 100 18F-FDG PET/CT for restaging in suspected recurrence or during follow-up. Histopathology results and/or clinical/imaging follow-up for at least 12 months were considered as reference standard. Moreover, the diagnostic accuracy and clinical impact of 18F-FDG PET/CT were calculated.
Results
Twenty-seven (27%) 18F-FDG PET/CT were positive, while the remaining 73 (73%) were negative. Sensitivity, specificity, PPV, NPV, and accuracy of PET/CT were 89% (95% CI 72–98%), 97% (95% CI 90–100%), 93% (95% CI 76–98%), 96% (95% CI 89–98%), and 95% (95% CI 89–98%). 18F-FDG PET/CT had a positive clinical impact in 18/100 studies changing the management, in 8 cases switching from local therapy to systemic therapy due to the detection of disseminate disease at PET/CT, in three cases recognizing relapse not detected by conventional imaging, and in 7 cases demonstrating to be true negative and avoiding unnecessary therapies.
Conclusions
18F-FDG PET/CT seems to be an accurate method for detection and localization of local and distant recurrence in GIST with good sensitivity and specificity and significant impact on clinical decision-making.