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J Cancer Res Ther. 2019 Jan-Mar;15(1):142-147. doi: 10.4103/jcrt.JCRT_1093_16.

Preoperative assessment of malignant potential of gastrointestinal stromal tumor by dual-time-point 18F-fluorodeoxyglucose positron emission tomography imaging: Usefulness of standardized uptake value and retention index.

Author information

1
Department of Family Medicine, Korea University College of Medicine, Seoul, Korea.
2
Department of Diagnostic Radiology, PET Center, Yale University, New Haven, CT, USA.
3
Department of Nuclear Medicine, Korea University College of Medicine, Seoul, Korea.
4
Department of Radiology, Korea University College of Medicine, Seoul, Korea.
5
Department of Nuclear Medicine, The State University of New York at Buffalo, Buffalo, NY, USA.
6
Department of Surgery, Division of Upper Gastrointestinal Surgery, Korea University College of Medicine, Seoul, Korea.

Abstract

Background:

To evaluate the usefulness of preoperative imaging with F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for noninvasive risk assessment of gastrointestinal stromal tumor (GIST).

Materials and Methods:

A retrospective review including 32 patients with pathologically proven GIST. Preoperative FDG-PET scan results including maximum standardized uptake values (SUVs) of the GISTs at 1 h postinjection (SUV1) were available for all tumors and SUVs at 2 h postinjection (SUV2) were available for 22 tumors. When both SUV1 and SUV2 were available, a retention index (RI, %) was calculated, and the correlation of these PET parameters with the histopathologic results was analyzed.

Results:

SUV1 was significantly higher in tumors in the high-risk group (6.0 ± 2.7) compared to those in the low risk (3.0 ± 1.6) or very low-risk (2.7 ± 1.2) groups (P = 0.009 and 0.011, respectively). At a cutoff of 5.2, the SUV1 demonstrated sensitivity of 80% and a specificity of 89% for predicting high-risk GISTs. Tumor size was significantly correlated with SUV1 (r = 0.68, P < 0.001) and SUV2 (r = 0.66, P = 0.001), and SUV1, SUV2, and RI were significantly higher in tumors with mitotic index > 5/50 high-power field than in those with lower mitotic index. RI was significantly higher in tumors with C-kit mutation than in those with no C-kit mutation.

Conclusion:

SUV1 measured during preoperative FDG-PET imaging correlated well with malignant potential of GISTs, especially for high-risk versus Low-/very-low-risk tumors. RI values correlated well with mitotic counts and C-kit mutation, suggesting that this mutation may have some influence on tumor metabolism.

KEYWORDS:

Gastrointestinal stromal tumor; positron emission tomography; retention index; standardized uptake value

PMID:
30880770
DOI:
10.4103/jcrt.JCRT_1093_16
[Indexed for MEDLINE]
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