Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Nuclear Medicine and Molecular Imaging
Published in: Nuclear Medicine and Molecular Imaging 2/2015

01-06-2015 | Original Article

Correlation of Primary Tumor FDG Uptake with Histopathologic Features of Advanced Gastric Cancer

Authors: Hae Won Kim, Kyoung Sook Won, Bong-Il Song, Yu Na Kang

Published in: Nuclear Medicine and Molecular Imaging | Issue 2/2015

Login to get access

Abstract

Purpose

Histopathologic features could affect the FDG uptake of primary gastric cancer and detection rate on FDG PET/CT. The aim of this study was to evaluate the FDG uptake of primary gastric cancer by correlating it with the histopathologic features of the tumors.

Methods

Fifty patients with locally advanced gastric adenocarcinoma who were referred for preoperative FDG-PET/CT scans were enrolled in this study. The detection rate of PET/CT and maximum standardized uptake values (SUVmax) of the primary tumor were compared using the WHO, Lauren, Ming and Borrmann classifications and tumor size and location.

Results

In 45 of the 50 patients (90 %), the primary gastric tumors were detected by FDG PET/CT. On comparison using the WHO classification, the detection rate and SUVmax of the tubular type were significantly higher than those of the poorly cohesive type. On comparison using the Lauren and Ming classifications, the SUVmaxs of the intestinal type and expanding type were significantly higher than those of the diffuse and infiltrative type, respectively. On comparison using the Borrmann classification and tumor size and location, there was no significant difference in the detection rate and SUVmax of primary gastric tumors.

Conclusion

This study demonstrates that the poorly cohesive type according to the WHO classification, diffuse type according to the Lauren classification and infiltrative type according to the Ming classification have low FDG uptake in patients with locally advanced gastric carcinoma. Understanding the relationship between primary tumor FDG uptake and histopathologic features would be helpful in detecting the primary tumor by FDG PET/CT in patients with gastric cancer.
Literature
1.
Guggenheim DE, Shah MA. Gastric cancer epidemiology and risk factors. J Surg Oncol. 2013;107:230–6.PubMedCrossRef
2.
Patru CL, Surlin V, Georgescu I, Patru E. Current issues in gastric cancer epidemiology. Rev Med Chir Soc Med Nat Iasi. 2013;117:199–204.PubMed
3.
4.
Luebke T, Baldus SE, Grass G, Bollschweiler E, Thiele J, Dienes HP, et al. Histological grading in gastric cancer by Ming classification: correlation with histopathological subtypes, metastasis, and prognosis. World J Surg. 2005;29:1422–7.PubMedCrossRef
5.
Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system. vol Ed. 4. World Health Organization; IARC Press, Lyon, 2010.
6.
Tschmelitsch J, Weiser MR, Karpeh MS. Modern staging in gastric cancer. Surg Oncol. 2000;9:23–30.PubMedCrossRef
7.
Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49.PubMed
8.
Lorenzen S, Blank S, Lordick F, Siewert JR, Ott K. Prediction of response and prognosis by a score including only pretherapeutic parameters in 410 neoadjuvant treated gastric cancer patients. Ann Surg Oncol. 2012;19:2119–27.PubMedCrossRef
9.
Cimerman M, Repse S, Jelenc F, Omejc M, Bitenc M, Lamovec J. Comparison of Lauren’s, Ming’s and WHO histological classifications of gastric cancer as a prognostic factor for operated patients. Int Surg. 1994;79:27–32.PubMed
10.
Adachi Y, Yasuda K, Inomata M, Sato K, Shiraishi N, Kitano S. Pathology and prognosis of gastric carcinoma: well versus poorly differentiated type. Cancer. 2000;89:1418–24.PubMedCrossRef
11.
Yang B, Wu G, Wang X, Zhang X. Discussion of modifying stage IV gastric cancer based on Borrmann classification. Tumour Biol. 2013;34:1485–91.PubMedCrossRef
12.
An JY, Kang TH, Choi MG, Noh JH, Sohn TS, Kim S. Borrmann type IV: an independent prognostic factor for survival in gastric cancer. J Gastroint Surg. 2008;12:1364–9.CrossRef
13.
Siewert JR, Bottcher K, Stein HJ, Roder JD. Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study. Ann Surg. 1998;228:449–61.PubMedCentralPubMedCrossRef
14.
Kunkel M, Forster GJ, Reichert TE, Jeong JH, Benz P, Bartenstein P, et al. Detection of recurrent oral squamous cell carcinoma by [18F]-2-fluorodeoxyglucose-positron emission tomography: implications for prognosis and patient management. Cancer. 2003;98:2257–65.PubMedCrossRef
15.
Soriano E, Faure C, Lantuejoul S, Reyt E, Bolla M, Brambilla E, et al. Course and prognosis of basaloid squamous cell carcinoma of the head and neck: a case–control study of 62 patients. Eur J Cancer. 2008;44:244–50.PubMedCrossRef
16.
Lin C, Itti E, Haioun C, Petegnief Y, Luciani A, Dupuis J, et al. Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med. 2007;48:1626–32.PubMedCrossRef
17.
Chung HW, Lee EJ, Cho YH, Yoon SY, So Y, Kim SY, et al. High FDG uptake in PET/CT predicts worse prognosis in patients with metastatic gastric adenocarcinoma. J Cancer Res Clin Oncol. 2010;136:1929–35.PubMedCrossRef
18.
Pak KH, Yun M, Cheong JH, Hyung WJ, Choi SH, Noh SH. Clinical implication of FDG-PET in advanced gastric cancer with signet ring cell histology. J Surg Oncol. 2011;104:566–70.PubMedCrossRef
19.
Lee JW, Lee SM, Lee MS, Shin HC. Role of 18F-FDG PET/CT in the prediction of gastric cancer recurrence after curative surgical resection. Eur J Nucl Med Mol Imaging. 2012;39:1425–34.PubMedCrossRef
20.
Stahl A, Ott K, Weber WA, Becker K, Link T, Siewert JR, et al. FDG PET imaging of locally advanced gastric carcinomas: correlation with endoscopic and histopathological findings. Eur J Nucl Med Mol Imaging. 2003;30(2):288–95.PubMedCrossRef
21.
Ma Q, Xin J, Zhao Z, Guo Q, Yu S, Xu W, et al. Value of 18F-FDG PET/CT in the diagnosis of primary gastric cancer via stomach distension. Eur J Radiol. 2013;82:e302–6.PubMedCrossRef
22.
Kim EY, Lee WJ, Choi D, Lee SJ, Choi JY, Kim BT, et al. The value of PET/CT for preoperative staging of advanced gastric cancer: comparison with contrast-enhanced CT. Eur J Radiol. 2011;79:183–8.PubMedCrossRef
23.
Berger KL, Nicholson SA, Dehdashti F, Siegel BA. FDG PET evaluation of mucinous neoplasms: correlation of FDG uptake with histopathologic features. Am J Roentgenol. 2000;174:1005–8.CrossRef
24.
Yun M, Lim JS, Noh SH, Hyung WJ, Cheong JH, Bong JK, et al. Lymph node staging of gastric cancer using (18)F-FDG PET: a comparison study with CT. J Nucl Med. 2005;46:1582–8.PubMed
25.
Fenoglio-Preiser CM, Noffsinger AE, Belli J, Stemmermann GN. Pathologic and phenotypic features of gastric cancer. Semin Oncol. 1996;23:292–306.PubMed
26.
Lauren PA, Nevalainen TJ. Epidemiology of intestinal and diffuse types of gastric carcinoma. A time-trend study in Finland with comparison between studies from high- and low-risk areas. Cancer. 1993;71:2926–33.PubMedCrossRef
27.
Moore GE, State D, et al. Carcinoma of the stomach; the validity of basing prognosis upon Borrmann typing or the presence of metastases. Surg Gynecol Obstet. 1948;87:513–8.PubMed
28.
Boucek JA, Francis RJ, Jones CG, Khan N, Turlach BA, Green AJ. Assessment of tumour response with (18)F-fluorodeoxyglucose positron emission tomography using three-dimensional measures compared to SUVmax–a phantom study. Phys Med Biol. 2008;53:4213–30.PubMedCrossRef
29.
Tian J, Chen L, Wei B, Shao M, Ding Y, Yin D, et al. The value of vesicant 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in gastric malignancies. Nucl Med Commun. 2004;25:825–31.PubMedCrossRef
30.
Herrmann K, Ott K, Buck AK, Lordick F, Wilhelm D, Souvatzoglou M, et al. Imaging gastric cancer with PET and the radiotracers 18F-FLT and 18F-FDG: a comparative analysis. J Nucl Med. 2007;48(12):1945–50.PubMedCrossRef
31.
Kim SK, Kang KW, Lee JS, Kim HK, Chang HJ, Choi JY, et al. Assessment of lymph node metastases using 18F-FDG PET in patients with advanced gastric cancer. Eur J Nucl Med Mol Imaging. 2006;33(2):148–55.PubMedCrossRef
32.
Mukai K, Ishida Y, Okajima K, Isozaki H, Morimoto T, Nishiyama S. Usefulness of preoperative FDG-PET for detection of gastric cancer. Gastric Cancer. 2006;9:192–6.PubMedCrossRef
33.
Clendenes Alvarado D, Cok Garcia J, Bussalleu RA. Histologic types of gastric cancer according to the Lauren classification at the Cayetano Heredia National Hospital. Rev Gastroenterol Peru. 1995;15:239–46.PubMed
34.
Kawamura T, Kusakabe T, Sugino T, Watanabe K, Fukuda T, Nashimoto A, et al. Expression of glucose transporter-1 in human gastric carcinoma: association with tumor aggressiveness, metastasis, and patient survival. Cancer. 2001;92:634–41.PubMedCrossRef
35.
Park JC, Lee JH, Cheoi K, Chung H, Yun MJ, Lee H, et al. Predictive value of pretreatment metabolic activity measured by fluorodeoxyglucose positron emission tomography in patients with metastatic advanced gastric cancer: the maximal SUV of the stomach is a prognostic factor. Eur J Nucl Med Mol Imaging. 2012;39:1107–16.PubMedCrossRef
36.
Vallbohmer D, Holscher AH, Schneider PM, Schmidt M, Dietlein M, Bollschweiler E, et al. [18F]-fluorodeoxyglucose-positron emission tomography for the assessment of histopathologic response and prognosis after completion of neoadjuvant chemotherapy in gastric cancer. J Surg Oncol. 2010;102:135–40.PubMedCrossRef
37.
Kim BS, Oh ST, Yook JH, Kim BS. Signet ring cell type and other histologic types: differing clinical course and prognosis in T1 gastric cancer. Surgery. 2014;155:1030–5.PubMedCrossRef
38.
Chen J, Cheong JH, Yun MJ, Kim J, Lim JS, Hyung WJ, et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography. Cancer. 2005;103:2383–90.PubMedCrossRef
39.
40.
Shim SS, Han J. FDG-PET/CT imaging in assessing mucin-producing non-small cell lung cancer with pathologic correlation. Ann Nucl Med. 2010;24:357–62.PubMedCrossRef
41.
Hu B, El Hajj N, Sittler S, Lammert N, Barnes R, Meloni-Ehrig A. Gastric cancer: classification, histology and application of molecular pathology. J Gastrointest Oncol. 2012;3:251–61.PubMedCentralPubMed
42.
Adler LP, Blair HF, Makley JT, Williams RP, Joyce MJ, Leisure G, et al. Noninvasive grading of musculoskeletal tumors using PET. J Nucl Med. 1991;32:1508–12.PubMed
43.
Padma MV, Said S, Jacobs M, Hwang DR, Dunigan K, Satter M, et al. Prediction of pathology and survival by FDG PET in gliomas. J Neuro-Oncol. 2003;64:227–37.CrossRef
44.
Soret M, Bacharach SL, Buvat I. Partial-volume effect in PET tumor imaging. J Nucl Med. 2007;48(6):932–45.PubMedCrossRef
Metadata
Title
Correlation of Primary Tumor FDG Uptake with Histopathologic Features of Advanced Gastric Cancer
Authors
Hae Won Kim
Kyoung Sook Won
Bong-Il Song
Yu Na Kang
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Nuclear Medicine and Molecular Imaging / Issue 2/2015
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-015-0327-3

Other articles of this Issue 2/2015

Nuclear Medicine and Molecular Imaging 2/2015 Go to the issue

Case Report

Lymphadenopathy by Scrub Typhus Mimicking Metastasis on FDG PET/CT in a Patient with a History of Breast Cancer

Interesting Image

Kikuchi Disease Mimicking Metastatic Lymphadenopathy on 18F-FDG PET/CT in Patients with Breast Cancer

Case Report

Changes in Skeletal Tumor Activity on 18F-choline PET/CT in Patients Receiving 223Radium Radionuclide Therapy for Metastatic Prostate Cancer

Erratum

Erratum to: Diagnostic Performance of 68Ga-DOTATATE PET/CT, 18F-FDG PET/CT and 131I-MIBG Scintigraphy in Mapping Metastatic Pheochromocytoma and Paraganglioma

Original Article

Diagnostic Performance of 68Ga-DOTATATE PET/CT, 18F-FDG PET/CT and 131I-MIBG Scintigraphy in Mapping Metastatic Pheochromocytoma and Paraganglioma

Review

Production of 177Lu for Targeted Radionuclide Therapy: Available Options