The role of pet/ct in monitoring treatment and prognosis of gastric cancer

Sara Zahmatkesh,1,* Mohammad hossein jamshidi,2

1. Department of Radiologic Technology, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2. Department of Radiologic Technology, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Abstract


Introduction

Fdg pet/ct is a useful modality to differentiate responders from nonresponders to neoadjuvant therapies to prevent side effects of unnecessary treatments and to optimize treatment approach by changing therapy to a second-line regimen. in a retrospective study of 130 patients, the patients’ management altered in 15% of the cases based on fdg pet/ct findings. also, fdg pet/ct provides prognostic information in gastric cancers.

Methods

Publications were retrieved by a systematic search of multiple bibliographic databases, including medline, embase, scopus, cochrane library, web of science, biomed central, science direct, and google scholar. the language of search was restricted to english.

Results

In a prospective study comprising 44 patients with locally advanced gastric cancer, the authors calculated a 2-year survival of 90% versus 25% for metabolic responders and nonresponders, respectively, 2 weeks after commencement of cisplatin-based chemotherapy (p = .002) the early diminished fdg uptake of primary gastric cancer is a prognostic factor representing favorable response to therapy, and better prognosis is presumed for patients with gastric cancer who experience a complete metabolic response to chemotherapy. moreover, there is a significant correlation between a high standardized uptake value (suv) of the primary gastric malignancy on fdg pet/ct and poor overall survival. in a retrospective study of 151 patients with metastatic lymph nodes from gastric cancer, song et al. shared the point that the preoperative suvmax of the involved lymph nodes on fdg pet/ct is an independent prognostic factor for both overall and recurrence-free survival.in addition, a high suv of the primary gastric tumor was correlated with malignant nodal involvement and noncurative surgery.

Conclusion

Finally, fdg pet/ct is a strong predictor of therapy response and an independent predictor of overall survival in patients with nonmetastatic esophageal cancer.

Keywords

Pet/ct, monitoring treatment, gastric cancer.