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Year : 2021  |  Volume : 5  |  Issue : 2  |  Page : 196-202

The Contribution of [18]F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography to the diagnosis and staging of signet-ring cell carcinoma of the stomach

1 Department of Nuclear Medicine, Private Gaziosmanpasa Hospital, Istanbul Yeni Yüzyil University, Istanbul, Turkey
2 Clinic of Nuclear Medicine, University of Health and Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey

Correspondence Address:
Esra Arslan
Istanbul Egitim ve Arastırma Hastanesi, Nukleer Tıp Kliniği, Org. Nafiz Gurman Caddesi, Samatya, Kocamustafapasa, Fatih, Istanbul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bbrj.bbrj_60_21

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Background: Signet ring cell carcinomas (SRCC) have been among the most common histological types of gastric cancer. In recent years, [18]F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography ([18]F-FDG-PET/CT) has been very useful for primary cancer staging and distant metastasis detection. In our study, the aim was to evaluate the diagnostic and predictive level of [18]F-FDG-PET/CT in SRCC. Methods: Ninetytwo patients that underwent [18]F-FDG-PET/CT procedures between 2011 and 2017 for primary staging were included in the study. The clinicopathological features and maximum standard uptake value (SUVmax) of histopathologically defined cancers were determined. Ethical approval was obtained from Istanbul Training and Research Hospital Local Ethics Committee with the date and number 04/08/2017-1048. Results: The mean age of the patients was 58.1 ± 12.2 years. Sixtythree of the patients (75.3%) were male and 29 (24.7%) were female. According to the histopathological classification, the majority of the SRCCs were poorly differentiated and were most frequently localized in the middle and lower parts of the stomach. The mean value of [18]F-FDG uptake by [18]F-FDG-PET/CT in the primary lesions was SUVmax = 9.69 ± 7.58. The mean SUVmax (SUVmax: 7.92) measured in the patient group, 60 years and older, was found to be statistically significantly higher (p = 0.038) than the value measured in the 59 years and younger group (SUVmax: 10.26). There was a statistically significant difference between the mean SUVmax of the patients aged 60 and over and under this age group (p = 0.038). A statistically significant difference was found between the group with a positive regional LN and the mean SUVmax calculated between the group with negative regional LN (p = 0.012). A statistically significant difference was found between the group with distant organ metastasis and the negative group (p = 0.008). However, no statistically significant difference was found between tumor diameter, tumor wall thickness, localization of the tumor in the stomach, presence of distant nodal metastasis, and SUVmax calculated for histological gradients of the lesions (p > 0.05). Conclusion: Due to the advances in the diagnosis and treatment of SRCC in recent years, PET/CT may contribute to the diagnosis, staging, and prognosis determination of patients. [18]F-FDG-PET/CT demonstrated high FDG uptake in SRCC lesions. The FDG SUVmax was observed to increase significantly in patients with SRCC diagnosis of regional LN and distant organ metastasis. Studies with larger patient groups are needed to detect locally advanced and metastatic cases in SRCC patients using [18]F-FDG-PET/CT.

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