Gastric GIST malignancy evaluated by 18FDG-PET as compared with EUS-FNA and endoscopic biopsy

Masahiro Yamada, Yasumasa Niwa, Tetsuo Matsuura, Ryouji Miyahara, Akira Ohashi, Osamu Maeda, Takafumi Ando, Naoki Omiya, Akihiro Itoh, Yoshiki Hirooka, Hidemi Goto

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective. The usefulness of 18F-fluoro-2-deoxyglucose positron emission tomography (18FDG-PET), whose high rate of FDG accumulation indicates high metabolism and malignant potential, has already been reported. The aims of this study were to evaluate the malignancy of primary gastrointestinal stromal tumour (GIST) in the stomach by 18FDG-PET and to correlate the FDG uptake values with known risk factors as determined by histology after EUS-guided fine needle aspiration (EUS-FNA) or endoscopic biopsy. Material and Methods. Of 29 patients with histologically proven GI-mesenchymal tumours, 21 with gastric GISTs underwent 18FDG-PET. Tumour size, mitotic index, Ki-67 labelling index (LI) and cellularity of the tumour tissue were compared with the standardized uptake value (SUV) of FDG. Results. Strong correlations were found between the SUV of FDG and EUS size, and mitotic index of EUS-FNA specimens (tumour size versus SUV, p=0.004, r=0.542; number of mitotic cells versus SUV, p=0.0078; n=21). Moreover, we examined the association between SUV and risk categories based on EUS-FNA findings using ROC curves. The cut-off values of FDG SUV were 2.2, 4.2 and 6.5 for the very low-, low-, intermediate- and high-risk groups, respectively. Conclusions. 18FDG-PET may be used to assess malignancy of GISTs. This image modality helps us determine the management strategy for these patients and complements the information on the biological behaviour and cellular proliferation of the tumours.

Original languageEnglish
Pages (from-to)633-641
Number of pages9
JournalScandinavian Journal of Gastroenterology
Volume42
Issue number5
DOIs
Publication statusPublished - 27-04-2007
Externally publishedYes

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Gastrointestinal Stromal Tumors
Deoxyglucose
Fine Needle Biopsy
Positron-Emission Tomography
Stomach
Neoplasms
Mitotic Index
ROC Curve
Histology
Cell Count
Cell Proliferation
Biopsy

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Yamada, Masahiro ; Niwa, Yasumasa ; Matsuura, Tetsuo ; Miyahara, Ryouji ; Ohashi, Akira ; Maeda, Osamu ; Ando, Takafumi ; Omiya, Naoki ; Itoh, Akihiro ; Hirooka, Yoshiki ; Goto, Hidemi. / Gastric GIST malignancy evaluated by 18FDG-PET as compared with EUS-FNA and endoscopic biopsy. In: Scandinavian Journal of Gastroenterology. 2007 ; Vol. 42, No. 5. pp. 633-641.
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title = "Gastric GIST malignancy evaluated by 18FDG-PET as compared with EUS-FNA and endoscopic biopsy",
abstract = "Objective. The usefulness of 18F-fluoro-2-deoxyglucose positron emission tomography (18FDG-PET), whose high rate of FDG accumulation indicates high metabolism and malignant potential, has already been reported. The aims of this study were to evaluate the malignancy of primary gastrointestinal stromal tumour (GIST) in the stomach by 18FDG-PET and to correlate the FDG uptake values with known risk factors as determined by histology after EUS-guided fine needle aspiration (EUS-FNA) or endoscopic biopsy. Material and Methods. Of 29 patients with histologically proven GI-mesenchymal tumours, 21 with gastric GISTs underwent 18FDG-PET. Tumour size, mitotic index, Ki-67 labelling index (LI) and cellularity of the tumour tissue were compared with the standardized uptake value (SUV) of FDG. Results. Strong correlations were found between the SUV of FDG and EUS size, and mitotic index of EUS-FNA specimens (tumour size versus SUV, p=0.004, r=0.542; number of mitotic cells versus SUV, p=0.0078; n=21). Moreover, we examined the association between SUV and risk categories based on EUS-FNA findings using ROC curves. The cut-off values of FDG SUV were 2.2, 4.2 and 6.5 for the very low-, low-, intermediate- and high-risk groups, respectively. Conclusions. 18FDG-PET may be used to assess malignancy of GISTs. This image modality helps us determine the management strategy for these patients and complements the information on the biological behaviour and cellular proliferation of the tumours.",
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Yamada, M, Niwa, Y, Matsuura, T, Miyahara, R, Ohashi, A, Maeda, O, Ando, T, Omiya, N, Itoh, A, Hirooka, Y & Goto, H 2007, 'Gastric GIST malignancy evaluated by 18FDG-PET as compared with EUS-FNA and endoscopic biopsy', Scandinavian Journal of Gastroenterology, vol. 42, no. 5, pp. 633-641. https://doi.org/10.1080/00365520601040450

Gastric GIST malignancy evaluated by 18FDG-PET as compared with EUS-FNA and endoscopic biopsy. / Yamada, Masahiro; Niwa, Yasumasa; Matsuura, Tetsuo; Miyahara, Ryouji; Ohashi, Akira; Maeda, Osamu; Ando, Takafumi; Omiya, Naoki; Itoh, Akihiro; Hirooka, Yoshiki; Goto, Hidemi.

In: Scandinavian Journal of Gastroenterology, Vol. 42, No. 5, 27.04.2007, p. 633-641.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Gastric GIST malignancy evaluated by 18FDG-PET as compared with EUS-FNA and endoscopic biopsy

AU - Yamada, Masahiro

AU - Niwa, Yasumasa

AU - Matsuura, Tetsuo

AU - Miyahara, Ryouji

AU - Ohashi, Akira

AU - Maeda, Osamu

AU - Ando, Takafumi

AU - Omiya, Naoki

AU - Itoh, Akihiro

AU - Hirooka, Yoshiki

AU - Goto, Hidemi

PY - 2007/4/27

Y1 - 2007/4/27

N2 - Objective. The usefulness of 18F-fluoro-2-deoxyglucose positron emission tomography (18FDG-PET), whose high rate of FDG accumulation indicates high metabolism and malignant potential, has already been reported. The aims of this study were to evaluate the malignancy of primary gastrointestinal stromal tumour (GIST) in the stomach by 18FDG-PET and to correlate the FDG uptake values with known risk factors as determined by histology after EUS-guided fine needle aspiration (EUS-FNA) or endoscopic biopsy. Material and Methods. Of 29 patients with histologically proven GI-mesenchymal tumours, 21 with gastric GISTs underwent 18FDG-PET. Tumour size, mitotic index, Ki-67 labelling index (LI) and cellularity of the tumour tissue were compared with the standardized uptake value (SUV) of FDG. Results. Strong correlations were found between the SUV of FDG and EUS size, and mitotic index of EUS-FNA specimens (tumour size versus SUV, p=0.004, r=0.542; number of mitotic cells versus SUV, p=0.0078; n=21). Moreover, we examined the association between SUV and risk categories based on EUS-FNA findings using ROC curves. The cut-off values of FDG SUV were 2.2, 4.2 and 6.5 for the very low-, low-, intermediate- and high-risk groups, respectively. Conclusions. 18FDG-PET may be used to assess malignancy of GISTs. This image modality helps us determine the management strategy for these patients and complements the information on the biological behaviour and cellular proliferation of the tumours.

AB - Objective. The usefulness of 18F-fluoro-2-deoxyglucose positron emission tomography (18FDG-PET), whose high rate of FDG accumulation indicates high metabolism and malignant potential, has already been reported. The aims of this study were to evaluate the malignancy of primary gastrointestinal stromal tumour (GIST) in the stomach by 18FDG-PET and to correlate the FDG uptake values with known risk factors as determined by histology after EUS-guided fine needle aspiration (EUS-FNA) or endoscopic biopsy. Material and Methods. Of 29 patients with histologically proven GI-mesenchymal tumours, 21 with gastric GISTs underwent 18FDG-PET. Tumour size, mitotic index, Ki-67 labelling index (LI) and cellularity of the tumour tissue were compared with the standardized uptake value (SUV) of FDG. Results. Strong correlations were found between the SUV of FDG and EUS size, and mitotic index of EUS-FNA specimens (tumour size versus SUV, p=0.004, r=0.542; number of mitotic cells versus SUV, p=0.0078; n=21). Moreover, we examined the association between SUV and risk categories based on EUS-FNA findings using ROC curves. The cut-off values of FDG SUV were 2.2, 4.2 and 6.5 for the very low-, low-, intermediate- and high-risk groups, respectively. Conclusions. 18FDG-PET may be used to assess malignancy of GISTs. This image modality helps us determine the management strategy for these patients and complements the information on the biological behaviour and cellular proliferation of the tumours.

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