Nuclear Techniques ›› 2014, Vol. 37 ›› Issue (12): 120301-120301.

### Filling gastric cavity with milk and meglumini diatrizoate improves the value of 18F-FDG PET/CT for diagnosing the gastric cancer

ZUO Wei WU Hubing WANG Quanshi LI Hongsheng ZHOU Wenlan DONG Ye

1. (Department of PET Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China)
• Received:2014-09-23 Revised:2014-10-10 Online:2014-12-10 Published:2014-12-04
• Supported by:

National Nature Science Foundation of China

Abstract:

Background: 18F-FDG PET/CT has been considered of limited value for detection of gastric cancer because of the digestive physiological motility, physiological uptake and inaccurate alignment PET/CT image. Purpose: The aim is to investigate the value of 18F-FDG PET/CT for diagnosing the gastric cancer using milk and meglumini diatrizoate for filling gastric cavity. Methods: Eight-one patients, who were suspected to have or needed to exclude gastric cancer, underwent 18F-FDG PET/CT scans. All of them were orally administrated with the mixture of milk and meglumini diatrizoate for filling the gastric cavity after the finish of routine 18F-FDG PET/CT whole body imaging. 10?20 min later, regional PET/CT scan for the stomach was performed. The clinical role of PET and PET/CT with and without gastric cavity filling for diagnosing the gastric cancer was assessed visually based on the results of the histopathologic diagnosis and clinical following up. Results: 51 of the 81 patients were diagnosed to have gastric cancer and 30 have benign gastric diseases. After the gastric cavity filling, the sensitivity and specificity of PET for the gastric cancer were improved from 60.7% to 82.3% (?2=5.829, P=0.016) and from 46.7% to 76.6% (?2=5.711, P=0.017). By combined analysis of the morphological abnormality showed on CT and metabolic abnormality on PET, CT improved the diagnose of the gastric cancer in 6 patients with negative on 18F-FDG PET. However, the sensitivity of PET/CT for the gastric cancer before and after the gastric cavity filling were respectively 88.2%, 94.1%, and the specificity were 83.3% and 90.0%, which was not significantly different (?2=0.487, P=0.484 and ?2=0.144, P=0.704). Filling gastric cavity with a mixture of milk and meglumini diatrizoate, the tumor lesion and the scope of tumor invasion can display more clearly (t=6.866, P=0.000), in 45.0% (23/51) of gastric cancer patients with diffuse disease or low 18F-FDG uptake, which prompt that CT image change would help to more accurately display and judge the extent of violations. Conclusion: The method of gastric cavity filling with the milk and meglumini diatrizoate can eliminate the influence of gastric physically uptake and improve the visualization of the tumor lesion and the scope of tumor invasion, though it can not significantly improve diagnostic accuracy.