(18)F-fluorodeoxyglucose positron emission tomography/computed tomography comparison of gastric lymphoma and gastric carcinoma

World J Gastroenterol. 2016 Sep 14;22(34):7787-96. doi: 10.3748/wjg.v22.i34.7787.

Abstract

Aim: To compare (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) features in gastric lymphoma and gastric carcinoma.

Methods: Patients with newly diagnosed gastric lymphoma or gastric carcinoma who underwent (18)F-FDG PET/CT prior to treatment were included in this study. We reviewed and analyzed the PET/CT features of gastric wall lesions, including FDG avidity, pattern (focal/diffuse), and intensity [maximal standard uptake value: (SUVmax)]. The correlation of SUVmax with gastric clinicopathological variables was investigated by χ(2) test, and receiver-operating characteristic (ROC) curve analysis was performed to determine the differential diagnostic value of SUVmax-associated parameters in gastric lymphoma and gastric carcinoma.

Results: Fifty-two patients with gastric lymphoma and 73 with gastric carcinoma were included in this study. Abnormal gastric FDG accumulation was found in 49 patients (94.23%) with gastric lymphoma and 65 patients (89.04%) with gastric carcinoma. Gastric lymphoma patients predominantly presented with type I and type II lesions, whereas gastric carcinoma patients mainly had type III lesions. The SUVmax (13.39 ± 9.24 vs 8.35 ± 5.80, P < 0.001) and SUVmax/THKmax (maximal thickness) (7.96 ± 4.02 vs 4.88 ± 3.32, P < 0.001) were both higher in patients with gastric lymphoma compared with gastric carcinoma. ROC curve analysis suggested a better performance of SUVmax/THKmax in the evaluation of gastric lesions between gastric lymphoma and gastric carcinoma in comparison with that of SUVmax alone.

Conclusion: PET/CT features differ between gastric lymphoma and carcinoma, which can improve PET/CT evaluation of gastric wall lesions and help differentiate gastric lymphoma from gastric carcinoma.

Keywords: 18F-fluorodeoxyglucose positron emission tomography/computed tomography; Differential diagnosis; Gastric carcinomas; Gastric lymphomas; Maximal standard uptake value; Maximal thickness.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / diagnostic imaging*
  • Carcinoma / pathology
  • Child
  • Female
  • Fluorodeoxyglucose F18 / chemistry
  • Humans
  • Lymphoma, Non-Hodgkin / diagnostic imaging*
  • Lymphoma, Non-Hodgkin / pathology
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography / methods*
  • ROC Curve
  • Radiopharmaceuticals / chemistry
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18

Supplementary concepts

  • Familial primary gastric lymphoma