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Eur J Radiol. 2017 Sep;94:160-166. doi: 10.1016/j.ejrad.2017.06.022. Epub 2017 Jun 27.

Clinical usefulness of F-18 FDG PET in lymphoepithelioma-like gastric carcinoma.

Author information

1
Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea.
2
Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea.
3
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
4
Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
5
Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.
6
Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: jkyoon3@ajou.ac.kr.

Abstract

PURPOSE:

Lymphoepithelioma-like carcinoma (LELC) is a rare type of gastric cancer. We evaluated the clinical usefulness of F-18 FDG positron emission tomography/computed tomography (PET/CT) in LELC of stomach.

MATERIALS AND METHODS:

A total of 28 patients (mean age=59years) who underwent preoperative F-18 FDG PET/CT were enrolled retrospectively. Nine patients underwent follow-up F-18 FDG PET/CT. Pathologic information was obtained through gastrectomy and the association with Epstein-Barr virus (EBV) was investigated in 26 patients.

RESULTS:

PET/CT detected 85.0% (17/20) of advanced gastric cancers (AGC) and 12.5% (1/8) of early gastric cancers (EGC). Most tumors (23/26, 88.5%) were EBV-associated. The maximum standardized uptake value of FDG-avid tumors was 7.5±3.0. The sensitivity and specificity of PET/CT for the presence of lymph node metastasis was 47.8% (11/23) and 100.0% (13/13), respectively. PET/CT also detected a hepatic sarcomatoid carcinoma in one patient. The specificity of PET/CT for distant metastasis or second malignancy was 96.3%. Follow-up PET/CT detected malignant lesions in 3 of 9 patients; a liver metastasis, recurrent hepatic sarcomatoid carcinomas and a metachronous cholangiocarcinoma. PET/CT correctly excluded recurrence in the rest of the patients (6/6). The sensitivity and specificity of PET/CT for detecting recurrence or second malignancy was 100% and 100%, respectively.

CONCLUSION:

F-18 FDG PET/CT would be a useful tool in evaluating distant metastasis or recurrence in patients with gastric LELC.

KEYWORDS:

Fluorodeoxyglucose F18; Lymphoepithelioma-like carcinoma; Positron emission tomography; Stomach neoplasms

PMID:
28712702
DOI:
10.1016/j.ejrad.2017.06.022
[Indexed for MEDLINE]

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