PET for gastric cancer – pro

Positron emission tomography using 2-deoxy-2-[18F] fluorodeoxyglucose (FDG-PET) has been used to detect malignancies associated with certain kinds of tumors. Data regarding the use of FDG-PET scan for evaluating gastric cancer are scarce. A recent review of studies showed that PET produced an estimated 14% change was noted in management effect, based on 109 patient studies for diagnosis/staging in gastric cancer; however, this is no randomized data.
Several Western guidelines state that PET is not routinely indicated for gastric cancer. This refers to both staging and restaging. Japanese literature (where this cancer is very common) is more suggestive that it may be useful in preoperative staging of lymph nodes (in Japan a wider lymph node dissection is performed than in the West) but it does not contain the same recommendations for PET for restaging. A recent review paper says: “POSITRON-EMISSION TOMOGRAPHY (PET) for these assessments may be useful although currently available data are limited.” NCCN says that PET is optional for staging.

Table of studies:, p.5

Analysis Ken Herrmann, Katja Ott, Andreas K. Buck, Florian Lordick, Dirk Wilhelm, Michael Souvatzoglou, Karen Becker, Tibor Schuster, Hans-Jürgen Wester, Jörg R. Siewert, Markus Schwaiger, and Bernd J. KrauseImaging Gastric Cancer with PET and the Radiotracers 18F-FLT and 18F-FDG: A Comparative  J Nucl Med 48: 1945-1950; First published on November 15, 2007;

Kota Mukai et al Usefulness of preoperative FDG-PET for detection of gastric cancer
Journal Gastric Cancer Volume 9, Number 3 / August, 2006

Chen, J, Cheong, JH, Yun, MJ, Kim, J, Lim, JS, Hyung, WJ  et al.  (2005) “Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography” Cancer 103: 2383-90

Scottish Intercollegiate Guidelines Network (SIGN). Management of oesophageal and gastric cancer. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2006 Jun. 69 p. (SIGN publication; no. 87). [393 references]

Dimitrios H Roukos and Angelos M Kappas Perspectives in the treatment of gastric cancerNature Clinical Practice Oncology (2005) 2, 98-107

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