The diagnostic value of PET/CT in benign and malignant lesions of the stomach

CUI Ying; ZHA NG Jian; FA NG Yi; ZUO Chang-jing

Abstract：Objective To investigate diagnostic value of PET/CT in benign and malignant lesions of the stomach .Meth-ods One hundred and thirty-eight patients with 18 F-FDG accumulations in gastrointestinal tract were correlated with endo-scopic and histopathologic findings .The accuracies of SUVmax and PET/CT for differentiating malignant from benign le-sions were compared by ROC curve analysis ,with a Z test to compare the AUC .The Kappa test ,t-test and Z-test andχ2 test were also used .Results Among the 138 stomach lesions ,there were 63% (87/138) malignant and 40% (51/138) be-nign lesions .SUVmax threshold value was 2 .97 ,sensitivity was 92.0% and specificity was 52.9% ;The SUVmax of Gastric malignant lesions was higher than that of benign lesions group ( t=5 .642 ,P=0 .001) ,the difference was statis-tically significant ;The Gastric wall thickness of malignant lesions was higher than that of benign lesions group (t =7.575 ,P =0.001) ,the difference was statistically significant ;To differentiate malignant from benign gastric lesions ,the AUC of SUVmax was 0.857 (95% CI 0.757~0 .916) .After analyzing the features of PET and CT images ,the AUC of PET/CT significantly was improved to 0.908(0.847~0.969) .The sensitivity ,specificity were 92.0% ,52.9% for SUV-max and 95 .4% ,92 .2% for PET/CT ,respectively .Agreement was fair for SUVmax (Kappa=0 .466 ,P=0 .001) ,and good for PET/CT (Kappa=0 .827 ,P =0 .001) .Compared with SUVmax ,the sensitivity of PET/CT was no statistical difference (χ2=0 .073 ,P =0 .787) ,while ,the specificity was significantly higher (χ2=19 .691 ,P =0 .001) .The sensi-tivity of PET/CT in detecting the mucinous adenocarcinoma and signet-ring cell carcinoma and other type cell carcinoma were 75% (12/16) and 95 .1% (58/61) respectively ,(t =1 .845 ,P =0.074) the difference was no statistically significant (Z=-1 .463,P =0.144) .Conclusion There is a higher sensitivi-ty ,specificity in these patients with examination of PET/CT than that of SUVmax ,when detecting the mucinous adeno-carcinoma and signet-ring cell carcinoma .There is a higher false negative in these patients with examination of PET/CT than in other type cell carcinoma .The clinical application value has been revealed that 18 F-FDG PET/CT in the diagnosis of benign and malignant lesions of stomach ,and qualitative advantage to stomach benign and malignant lesions of the diag-nosis and treatment of project establishment was of great help .