Preoperative assessment and prognostic prediction of gastric cancer patients with peritoneal metastasis using ¹⁸F-FDG PET/CT before conversion surgery.

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Research Pub Date : 2025-04-21 DOI:10.1186/s13550-025-01244-4

Yao Peng, Min Shi, Daxi Xiong, Sheng Lu, Ying Miao, Hong Yuan, Chao Yan, Zhenggang Zhu, Biao Li, Zhongyin Yang, Jiajia Hu

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引用次数: 0

Abstract

Background: Conversion therapy followed by conversion surgery (CS) can improve the prognosis of gastric cancer (GC) patients with peritoneal metastasis (PM). However, patients benefit differently. There is no way to confirm the prognostic benefit non-invasively and early. This retrospective study assessed the value of ¹⁸F-FDG PET/CT after conversion therapy in preoperative assessment and prognostic prediction of GC patients with PM.

Results: Fifty-one GC patients with PM were enrolled. ¹⁸F-FDG PET/CT after conversion therapy helped in preoperative assessment. Its diagnostic accuracy for residual peritoneal lesions was slightly better than contrast-enhanced CT (72.5% vs. 61.2%, P = 0.229), although the difference was not statistically significant. TBR of peritoneal lesions could help preoperative assessment, with TBR of peritoneal lesions to the mediastinal blood pool SUVmax (TBRAmaxp) as the best predictor (cutoff = 0.705, specificity 80%, sensitivity 80%, AUC 0.825, P < 0.001). Additionally, PET/CT could predict prognosis and assess surgical benefit. SUVmax of peritoneal lesions (SUVmaxp) was the best predictor of 24 months survival (cutoff = 1.466, AUC 0.870, P = 0.002, Specificity 77.8%, Sensitivity 83.3%) and metabolic parameters of peritoneal lesions could predict OS and the prognosis of patients who underwent CS.

Conclusion: ¹⁸F-FDG PET/CT provides quantitative imaging indicators for preoperative evaluation and prognostic prediction in GC patients with PM.

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胃癌腹膜转移患者转换术前18F-FDG PET/CT评估及预后预测

背景：胃癌（GC）合并腹膜转移（PM）患者经转化治疗后再行转化手术（CS）可改善预后。然而，患者受益不同。没有办法在非侵入性和早期确认预后益处。本回顾性研究评估了转换治疗后18F-FDG PET/CT在GC合并PM患者术前评估和预后预测中的价值。结果：51例GC合并PM患者入组。转换治疗后的18F-FDG PET/CT有助于术前评估。其对腹膜残余病变的诊断准确率略高于对比增强CT (72.5% vs. 61.2%, P = 0.229)，但差异无统计学意义。腹膜病变TBR有助于术前评估，其中腹膜病变TBR对纵隔血池SUVmax （TBRAmaxp）为最佳预测指标（截止值= 0.705，特异性80%，敏感性80%，AUC 0.825， P）结论：18F-FDG PET/CT为GC合并PM患者的术前评估和预后预测提供了定量成像指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.