Kanae Kawai Miyake1, Yuji Nakamoto2, Yoshiki Mikami3,4, Shiro Tanaka5, Tatsuya Higashi6, Eiji Tadamura7, Tsuneo Saga8, Shunsuke Minami9, Kaori Togashi2. 1. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan. kanaek@kuhp.kyoto-u.ac.jp. 2. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan. 3. Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan. 4. Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan. 5. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan. 6. Shiga Medical Center Research Institute, Shiga, Japan. 7. Department of Radiology, Sakazaki Clinic, Kyoto, Japan. 8. Dianostic Imaging Group, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan. 9. Department of Radiology, Shiga Medical Center for Adults, Shiga, Japan.
Abstract
OBJECTIVES: To assess the potential value of preoperative 18F-FDG PET to predict postoperative recurrence of solitary localized primary gastrointestinal stromal tumour (GIST) after radical resection. METHODS: A total of 46 patients with primary GIST who received preoperative 18F-FDG PET and underwent complete resection without neoadjuvant therapy were retrospectively studied. PET findings, including ring-shaped uptake and intense uptake, were compared with Joensuu risk grades using Fisher's exact test. The prognostic value of the preoperative clinico-imaging variables-age ≥60 years, male, ring-shaped uptake, intense uptake, tumour size >5 cm, heterogeneous CT attenuation and lower gastrointestinal origin-and Joensuu high risk for recurrence-free survival was evaluated using log-rank test and multivariate Cox regression analysis. RESULTS: Ring-shaped uptake and intense uptake were significantly associated with Joensuu high risk. Univariate analysis showed that ring-shaped uptake, intense uptake, size >5 cm and Joensuu high risk were significantly associated with inferior recurrence-free survival. Multivariate analysis showed that ring-shaped uptake (P = 0.004) and Joensuu high risk (P = 0.021) were independent adverse prognostic factors of postoperative recurrence. CONCLUSIONS: Ring-shaped uptake on preoperative 18F-FDG PET may be a potential predictor of postoperative tumour recurrence of localized primary GISTs. KEY POINTS: • Clinical course of resectable solitary localized primary GISTs varies widely. • Ring-shaped uptake is an independent adverse prognostic factor of postoperative recurrence. • Preoperative 18 F-FDG PET may help predict postoperative recurrence of GISTs.
OBJECTIVES: To assess the potential value of preoperative 18F-FDG PET to predict postoperative recurrence of solitary localized primary gastrointestinal stromal tumour (GIST) after radical resection. METHODS: A total of 46 patients with primary GIST who received preoperative 18F-FDG PET and underwent complete resection without neoadjuvant therapy were retrospectively studied. PET findings, including ring-shaped uptake and intense uptake, were compared with Joensuu risk grades using Fisher's exact test. The prognostic value of the preoperative clinico-imaging variables-age ≥60 years, male, ring-shaped uptake, intense uptake, tumour size >5 cm, heterogeneous CT attenuation and lower gastrointestinal origin-and Joensuu high risk for recurrence-free survival was evaluated using log-rank test and multivariate Cox regression analysis. RESULTS: Ring-shaped uptake and intense uptake were significantly associated with Joensuu high risk. Univariate analysis showed that ring-shaped uptake, intense uptake, size >5 cm and Joensuu high risk were significantly associated with inferior recurrence-free survival. Multivariate analysis showed that ring-shaped uptake (P = 0.004) and Joensuu high risk (P = 0.021) were independent adverse prognostic factors of postoperative recurrence. CONCLUSIONS: Ring-shaped uptake on preoperative 18F-FDG PET may be a potential predictor of postoperative tumour recurrence of localized primary GISTs. KEY POINTS: • Clinical course of resectable solitary localized primary GISTs varies widely. • Ring-shaped uptake is an independent adverse prognostic factor of postoperative recurrence. • Preoperative 18 F-FDG PET may help predict postoperative recurrence of GISTs.
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