|Table of Contents|

Diagnostic performance of whole-body dynamic 18F-FDG PET/CT to differentiate between inflammation and recurrence at the anastomosis from upper gastrointestinal tumors after surgery

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 04
Page:
697-703
Research Field:
Publishing date:

Info

Title:
Diagnostic performance of whole-body dynamic 18F-FDG PET/CT to differentiate between inflammation and recurrence at the anastomosis from upper gastrointestinal tumors after surgery
Author(s):
LYU Tao; XU Yue; ZHAO Yihan; YU Wenjing; ZHU Gan; WANG Hui; SI Hongwei
Department of Nuclear Medicine,the First Affiliated Hospital of Anhui Medical University,Anhui Hefei 230022,China.
Keywords:
gastric cancer; esophageal cancer; anastomosis; dynamic PET; differential diagnosis; metabolic rate
PACS:
R735
DOI:
10.3969/j.issn.1672-4992.2024.04.019
Abstract:
Objective:To investigate the clinical value of whole-body dynamic 18F-FDG PET/CT in monitoring recurrence and inflammation at the anastomosis from upper gastrointestinal tumors after the radical operation.Methods:A total of 53 patients (29 cases of gastric cancer and 24 cases of esophageal cancer) with abnormal FDG uptake at the anastomotic site after whole-body dynamic 18F-FDG PET/CT examination were retrospectively analyzed.According to the results of gastroscopic pathology and other imaging examinations before and after PET/CT examination,the patients were divided into an anastomotic recurrence group and an anastomotic inflammation group,respectively.The metabolic parameters MRFDG and DVmax of anastomotic lesions and MRmean and DVmean of normal liver tissue were obtained by Patlak multiparameter analysis software.The MRFDG and DVmax of anastomotic lesions were divided by the MRmean and DVmean of normal liver tissue to calculate lesion-to-background ratios (LBRs) and then obtaine LBR-MRFDG and LBR-DVmax.The independent sample t-test was used for statistical analysis,and the receiver operating characteristic (ROC) curve was used to analyze the differential diagnostic efficacy of each parameter between recurrence and inflammation at the anastomosis.Results:The dynamic 18F-FDG PET/CT imaging parameters MRFDG,DVmax and their LBRs (LBR-MRFDG and LBR-DVmax) of anastomotic lesions were significantly different between the recurrence group and the inflammation group (P＜0.05).And the parameter LBR-MRFDG showed better diagnostic efficacy in the differential diagnosis of anastomotic inflammation and recurrent lesions.The AUC value was 0.935［0.778,0.993］ with a threshold of 1.83 in gastric cancer group and 0.927［0.743,0.993］ with a threshold of 1.86 in esophageal cancer group.Conclusion:Whole-body dynamic 18F-FDG PET/CT imaging can accurately distinguish anastomotic recurrence and inflammation after gastric and esophageal cancer surgery,and has the potential to become an effective monitoring method for patients with upper gastrointestinal cancer after surgical treatment.

References:

[1] 王凯瑞,赵多文,王嘉彤,等.18F-FDG PET/CT在胃癌诊断中应用价值［J］.中华肿瘤防治杂志,2020,27(7):554-558. WANG KR,ZHAO DW,WANG JT,et al.Value of 18F-FDG PET/CT indiagnosis of gastric cancer［J］.Chinese Journal of Cancer Prevention and Treatment,2020,27(7):554-558.
[2]董文婷,李绍洁,侯琛琛,等.18F-FDG PET/CT显像在胃癌分期鉴别及预后评估中的价值研究［J］.中国医学装备,2021,18(4):83-86. DONG WT,LI SJ,HOU CC,et al.Research on the value of 18F-FDG PET/CT imaging in the staging identification and prognostic assessment of gastric carcinoma［J］.China Medical Equipment,2021,18(4):83-86.
[3] 王姝,李雪娜,刁尧,等.18F-FDG PET及PET/CT在食管癌复发转移的诊断与术后慢性炎症鉴别诊断中的应用:Meta分析［J］.现代肿瘤医学,2019,27(15):2740-2744. WANG S,LI XN,DIAO Y,et al.Use of 18F-FDG PET and PET/CT in differential diagnosis between recurrent or metastatic and chronic inflammation of esophageal cancer after treatment:A Meta analysis［J］.Modern Oncology,2019,27(15):2740-2744.
[4] MATSUOKA T,YASHIRO M.Biomarkers of gastric cancer:current topics and future perspective［J］.World J Gastroenterol,2018,24(26):2818-2832.
[5] MRIDA DE LA TORRE FJ,MORENO CAMPOY EE.Diagnostic role of tumor markers［J］.Medicina Clínica (English Edition),2019,152(5):185-187.
[6] 张巍,王艳.CT平扫与MSCT双期增强鉴别早期肝细胞癌效果研究［J］.辽宁医学杂志,2021,35(6):47-50. ZHANG W,WANG Y.The effect of CT plain scan and MSCT double stage enhancement in differentiating small cell carcinoma of liver［J］.Medical Journal of Liaoning,2021,35(6):47-50.
[7] LEE JW,LEE SM,LEE MS,et al.Role of 18F-FDG PET/CT in the prediction of gastric cancer recurrence after curative surgical resection［J］.Eur J Nucl Med Mol Imaging,2012,39(9):1425-1434.
[8] PIJL JP,NIENHUIS PH,KWEE TC,et al.Limitations and pitfalls of FDG PET/CT in infection and inflammation［J］.Semin Nucl Med,2021,51(6):633-645.
[9] FENG T,ZHAO Y,SHI H,et al.Total-body quantitative parametric imaging of early kinetics of 18F-FDG［J］.J Nucl Med,2021,62(5):738-744.
[10] DIMITRAKOPOULOU-STRAUSS A,PAN L,SACHPEKIDIS C.Kinetic modeling and parametric imaging with dynamic PET for oncological applications:general considerations,current clinical applications,and future perspectives［J］.Eur J Nucl Med Mol Imaging,2021,48(1):21-39.
[11] LI G,YANG S,WANG S,et al.Diagnostic value of dynamic 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) in cervical lymph node metastasis of nasopharyngeal cancer［J］.Diagnostics (Basel),2023,13(15):2530.
[12] ZAKER N,KOTASIDIS F,GARIBOTTO V,et al.Assessment of lesion detectability in dynamic whole-body PET imaging using compartmental and Patlak parametric mapping［J］.Clin Nucl Med,2020,45(5):e221-e231.
[13] FAHRNI G,KARAKATSANIS NA,DI DOMENICANTONIO G,et al.Does whole-body Patlak 18F-FDG PET imaging improve lesion detectability in clinical oncology［J］.Eur Radiol,2019,29(9):4812-4821.
[14] NAKAJO M,OJIMA S,KAWAKAMI H,et al.Value of Patlak Ki images from 18F-FDG-PET/CT for evaluation of the relationships between disease activity and clinical events in cardiac sarcoidosis［J］.Sci Rep,2021,11(1):2729-2738.
[15] KAJRY K,LENGYEL Z,TKS AM,et al.Dynamic FDG-PET/CT in the initial staging of primary breast cancer:clinicopathological correlations［J］.Pathol Oncol Res,2020,26(2):997-1006.
[16] RAHMIM A,LODGE MA,KARAKATSANIS NA,et al.Dynamic whole-body PET imaging:principles,potentials and applications［J］.Eur J Nucl Med Mol Imaging,2019,46(2):501-518.
[17] SKAWRAN S,MESSERLI M,KOTASIDIS F,et al.Can dynamic whole-body FDG PET imaging differentiate between malignant and inflammatory lesions［J］.Life (Basel),2022,12(9):1350-1363.
[18] YANG Z,ZAN Y,ZHENG X,et al.Dynamic FDG-PET imaging to differentiate malignancies from inflammation in subcutaneous and in situ mouse model for non-small cell lung carcinoma (NSCLC)［J］.PLoS One,2015,10(9):e0139089.
[19] MARIN A,MURCHISON JT,SKWARSKI KM,et al.Can dynamic imaging,using 18F-FDG PET/CT and CT perfusion differentiate between benign and malignant pulmonary nodules［J］.Radiol Oncol,2021,55(3):259-267.
[20] THUILLIER P,BOURHIS D,KARAKATSANIS N,et al.Diagnostic performance of a whole-body dynamic 68GA-DOTATOC PET/CT acquisition to differentiate physiological uptake of pancreatic uncinate process from pancreatic neuroendocrine tumor［J］.Medicine (Baltimore),2020,99(33):e20021.
[21] WANG H,MIAO Y,YU W,et al.Improved clinical workflow for whole-body Patlak parametric imaging using two short dynamic acquisitions［J］.Front Oncol,2022,12:822708.
[22] KARAKATSANIS NA,CASEY ME,LODGE MA,et al.Whole-body direct 4D parametric PET imaging employing nested generalized Patlak expectation-maximization reconstruction［J］.Phys Med Biol,2016,61(15):5456-5485.
[23] HAN WH,OH YJ,EOM BW,et al.Prognostic impact of infectious complications after curative gastric cancer surgery［J］.Eur J Surg Oncol,2020,46(7):1233-1238.
[24] XU QL,LI H,ZHU YJ,et al.The treatments and postoperative complications of esophageal cancer:a review［J］.J Cardiothorac Surg,2020,15(1):163-173.
[25] 张敬勉,赵新明,王建方,等.18F- FDG PET/CT显像对胃癌治疗后临床再分期及治疗决策的影响［J］.中国全科医学,2013,16(4):1360-1365. ZHANG JM,ZHAO XM,WANG JF,et al.Impact of 18F-FDG PET/CT on the clinical restaging and therapeutic regimens in post-treatment patients with gastric carcinoma［J］.Chinese General Practice,2013,16(4):1360-1365.
[26] DIAS AH,PEDERSEN MF,DANIELSEN H,et al.Clinical feasibility and impact of fully automated multi-parametric PET imaging using direct Patlak reconstruction:evaluation of 103 dynamic whole-body 18F-FDG PET/CT scans［J］.Eur J Nucl Med Mol Imaging,2021,48(3):837-850.
[27] ALAKUS H,BATUR M,SCHMIDT M,et al.Variable 18F-fluorodeoxyglucose uptake in gastric cancer is associated with different levels of GLUT-1 expression［J］.Nucl Med Commun,2010,31(6):532-538.
[28] CELIKER-GULER E,RUDDY TD,WELLS RG.Acquisition,processing,and interpretation of 18F-FDG PET viability and inflammation studies［J］.Curr Cardiol Rep,2021,23(9):124-131.
[29] KOBAYASHI M,KAIDA H,KAWAHARA A,et al.The relationship between GLUT-1 and vascular endothelial growth factor expression and 18F-FDG uptake in esophageal squamous cell cancer patients［J］.Clin Nucl Med,2012,37(5):447-452.
[30] WEISSINGER M,ATMANSPACHER M,SPENGLER W,et al.Diagnostic performance of dynamic whole-body Patlak 18F-FDG-PET/CT in patients with indeterminate lung lesions and lymph nodes［J］.J Clin Med,2023,12(12):3942.
[31]WUMENER X,ZHANG Y,WANG Z,et al.Dynamic FDG-PET imaging for differentiating metastatic from non-metastatic lymph nodes of lung cancer［J］.Front Oncol,2022,12:1005924.

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Last Update: 1900-01-01