Application value of 18 F - FDG PET/CT in differential diagnosis of linitis plastica and normal gastric cavity with poorly water filling

Cheng Bing; Xie Xinli; Han Xingmin; Liu Baoping; Han Jun

doi:10.3969/j.issn.1004-437X.2015.08.007

Abstract：Objective To clarify the characteristics of fluorine - 18 fluorodeoxyglucose positron emission tomography/ compu-ted tomography(18 F - FDG PET/ CT)findings of linitis plastica,and explore the application value of 18 F - FDG PET/ CT in dif-ferential diagnosis of linitis plastica and normal gastric cavity with poorly water filling. Methods The characteristics of 18 F -FDG PET/ CT findings in 18 patients with linitis plastica confirmed by pathology. The standardized uptake value - maximum (SUVmax)of the gastric wall was calculated and compared with 46 cases of normal gastric cavity with poorly water filling. Re-sults Among the 18 cases of linitis plastica,12 cases showed low to moderate level of 18 F - FDG uptake. 9 cases of linitis plas-tica were confirmed by PET/ CT and 2 cases were misdiagnosed as physiological uptake. Other 7 cases could not be differentiated from physiological uptake or inflammatory. There was no significant difference in SUVmax before water intake between linitis plas-tica and normal gastric cavity(Z = - 0. 829,P = 0. 407). After water intake,the change of SUVmax in linitis plastica group was not obvious,and the FDG intake of gastric wall in patients with normal gastric cavity with poorly water filling was significantly de-creased( Z = - 5. 126,P = 0. 001). Conclusion 18 F - FDG PET/ CT could not effectively distinguish physiological uptake of poorly gastric filling from linitis plastica. Water intake may be useful to prevent misdiagnosis. The diagnostic value of this tech-nique based on SUVmax is limited. For patients with gastric wall thickening diagnosed by CT,18 F - FDG PET/ CT examination after water intake may be the good choice to advoid missed diagnosis.