RadioGraphics
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

DOI: 10.1148/rg.261055078
This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lim, J. S.
Right arrow Articles by Kim, K. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lim, J. S.
Right arrow Articles by Kim, K. W.
Related Collections
Right arrow Nuclear Medicine
Right arrow Computed Tomography
Right arrow Gastrointestinal Radiology

CT and PET in Stomach Cancer: Preoperative Staging and Monitoring of Response to Therapy1

Joon Seok Lim, MD, Mi Jin Yun, MD, Myeong-Jin Kim, MD, Woo Jin Hyung, MD, Mi-Suk Park, MD, Jin-Young Choi, MD, Tae-Sung Kim, MD, Jong Doo Lee, MD, Sung Hoon Noh, MD and Ki Whang Kim, MD

1 From the Departments of Diagnostic Radiology (J.S.L., M.J.K., M.S.P., J.Y.C., K.W.K.), Nuclear Medicine (M.J.Y., T.S.K., J.D.L.), and Surgery (W.J.H., S.H.N.), Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-ku, Seoul, 120–752, Republic of Korea. Presented as an education exhibit at the 2004 RSNA Annual Meeting. Received April 4, 2005; revision requested April 28 and received June 1; accepted June 13. All authors have no financial relationships to disclose.

Figure 1
View larger version (133K):

[in a new window]
  		Figure 1a.  Stage T1–T4 gastric tumors. (a) Coronal reformatted image shows a stage T1 tumor (arrows) with focal nontransmural enhancement in the upper body. (b) Axial CT scan shows a stage T2 tumor (arrow), a localized, transmurally enhancing ulcerative mass without perigastric extension, in the lower body. (c) Coronal reformatted image shows a stage T3 tumor (arrows), with gross infiltration of the perigastric fat tissue in the antrum. (d) Axial CT scan shows a stage T4 tumor with invasion of the colon. The tumor represents an advanced cancer of the antrum and is accompanied by obliteration of the fat plane and thickening of the colonic wall (arrows). (e) Coronal reformatted image shows a stage T4 tumor (arrow) infiltrating the distal pancreatic body. (f) Axial CT scan shows a stage T4 tumor (arrows), an advanced cancer with gross infiltration of the lateral segment of the liver.

 

Figure 1
View larger version (129K):

[in a new window]
  		Figure 1b.  Stage T1–T4 gastric tumors. (a) Coronal reformatted image shows a stage T1 tumor (arrows) with focal nontransmural enhancement in the upper body. (b) Axial CT scan shows a stage T2 tumor (arrow), a localized, transmurally enhancing ulcerative mass without perigastric extension, in the lower body. (c) Coronal reformatted image shows a stage T3 tumor (arrows), with gross infiltration of the perigastric fat tissue in the antrum. (d) Axial CT scan shows a stage T4 tumor with invasion of the colon. The tumor represents an advanced cancer of the antrum and is accompanied by obliteration of the fat plane and thickening of the colonic wall (arrows). (e) Coronal reformatted image shows a stage T4 tumor (arrow) infiltrating the distal pancreatic body. (f) Axial CT scan shows a stage T4 tumor (arrows), an advanced cancer with gross infiltration of the lateral segment of the liver.

 

Figure 1
View larger version (126K):

[in a new window]
  		Figure 1c.  Stage T1–T4 gastric tumors. (a) Coronal reformatted image shows a stage T1 tumor (arrows) with focal nontransmural enhancement in the upper body. (b) Axial CT scan shows a stage T2 tumor (arrow), a localized, transmurally enhancing ulcerative mass without perigastric extension, in the lower body. (c) Coronal reformatted image shows a stage T3 tumor (arrows), with gross infiltration of the perigastric fat tissue in the antrum. (d) Axial CT scan shows a stage T4 tumor with invasion of the colon. The tumor represents an advanced cancer of the antrum and is accompanied by obliteration of the fat plane and thickening of the colonic wall (arrows). (e) Coronal reformatted image shows a stage T4 tumor (arrow) infiltrating the distal pancreatic body. (f) Axial CT scan shows a stage T4 tumor (arrows), an advanced cancer with gross infiltration of the lateral segment of the liver.

 

Figure 1
View larger version (128K):

[in a new window]
  		Figure 1d.  Stage T1–T4 gastric tumors. (a) Coronal reformatted image shows a stage T1 tumor (arrows) with focal nontransmural enhancement in the upper body. (b) Axial CT scan shows a stage T2 tumor (arrow), a localized, transmurally enhancing ulcerative mass without perigastric extension, in the lower body. (c) Coronal reformatted image shows a stage T3 tumor (arrows), with gross infiltration of the perigastric fat tissue in the antrum. (d) Axial CT scan shows a stage T4 tumor with invasion of the colon. The tumor represents an advanced cancer of the antrum and is accompanied by obliteration of the fat plane and thickening of the colonic wall (arrows). (e) Coronal reformatted image shows a stage T4 tumor (arrow) infiltrating the distal pancreatic body. (f) Axial CT scan shows a stage T4 tumor (arrows), an advanced cancer with gross infiltration of the lateral segment of the liver.

 

Figure 1
View larger version (141K):

[in a new window]
  		Figure 1e.  Stage T1–T4 gastric tumors. (a) Coronal reformatted image shows a stage T1 tumor (arrows) with focal nontransmural enhancement in the upper body. (b) Axial CT scan shows a stage T2 tumor (arrow), a localized, transmurally enhancing ulcerative mass without perigastric extension, in the lower body. (c) Coronal reformatted image shows a stage T3 tumor (arrows), with gross infiltration of the perigastric fat tissue in the antrum. (d) Axial CT scan shows a stage T4 tumor with invasion of the colon. The tumor represents an advanced cancer of the antrum and is accompanied by obliteration of the fat plane and thickening of the colonic wall (arrows). (e) Coronal reformatted image shows a stage T4 tumor (arrow) infiltrating the distal pancreatic body. (f) Axial CT scan shows a stage T4 tumor (arrows), an advanced cancer with gross infiltration of the lateral segment of the liver.

 

Figure 1
View larger version (117K):

[in a new window]
  		Figure 1f.  Stage T1–T4 gastric tumors. (a) Coronal reformatted image shows a stage T1 tumor (arrows) with focal nontransmural enhancement in the upper body. (b) Axial CT scan shows a stage T2 tumor (arrow), a localized, transmurally enhancing ulcerative mass without perigastric extension, in the lower body. (c) Coronal reformatted image shows a stage T3 tumor (arrows), with gross infiltration of the perigastric fat tissue in the antrum. (d) Axial CT scan shows a stage T4 tumor with invasion of the colon. The tumor represents an advanced cancer of the antrum and is accompanied by obliteration of the fat plane and thickening of the colonic wall (arrows). (e) Coronal reformatted image shows a stage T4 tumor (arrow) infiltrating the distal pancreatic body. (f) Axial CT scan shows a stage T4 tumor (arrows), an advanced cancer with gross infiltration of the lateral segment of the liver.

 

Figure 2
View larger version (108K):

[in a new window]
  		Figure 2a.  Signet ring cell carcinoma without significant FDG uptake in a 30-year-old woman with stomach cancer. (a) Axial CT scan shows diffuse thickening of nearly the entire gastric wall (arrowheads) due to linitis plastica. (b) Coronal PET scan shows no discernible FDG uptake in the stomach (arrows).

 

Figure 2
View larger version (89K):

[in a new window]
  		Figure 2b.  Signet ring cell carcinoma without significant FDG uptake in a 30-year-old woman with stomach cancer. (a) Axial CT scan shows diffuse thickening of nearly the entire gastric wall (arrowheads) due to linitis plastica. (b) Coronal PET scan shows no discernible FDG uptake in the stomach (arrows).

 

Figure 3
View larger version (78K):

[in a new window]
  		Figure 3.  Drawing illustrates lymph node locations according to the Japanese Research Society for Gastric Cancer (28). 1 = right paracardium, 2 = left paracardium, 3 = lesser curvature, 4 = greater curvature, 5 = suprapylorum, 6 = infrapylorum, 7 = left gastric artery, 8 = common hepatic artery, 9 = celiac artery, 10 = splenic hilum, 11 = proximal splenic artery, 12 = hepatoduodenal ligament, 13 = posterior surface of the pancreatic head, 14 = superior mesenteric vessels (SMA = superior mesenteric artery, SMV = superior mesenteric vein), 15 = middle colic vessels, 16 = abdominal aorta.

 

Figure 4
View larger version (137K):

[in a new window]
  		Figure 4a.  Station 7 and 8 lymph node metastases in a 63-year-old man with stomach cancer. (a) Axial CT scan demonstrates a station 7 lymph node (white arrowhead) adjacent to the left gastric artery (white arrow) and a station 8 lymph node (black arrowhead) adjacent to the common hepatic artery (black arrow). The diagnosis of lymph node metastasis may be difficult if only size criteria are used. (b) Axial PET scan shows prominent FDG uptake in the corresponding station 7 (arrowhead) and station 8 (arrow) lymph nodes, a finding that suggests metastasis. Lymph node metastasis was proved at pathologic analysis.

 

Figure 4
View larger version (87K):

[in a new window]
  		Figure 4b.  Station 7 and 8 lymph node metastases in a 63-year-old man with stomach cancer. (a) Axial CT scan demonstrates a station 7 lymph node (white arrowhead) adjacent to the left gastric artery (white arrow) and a station 8 lymph node (black arrowhead) adjacent to the common hepatic artery (black arrow). The diagnosis of lymph node metastasis may be difficult if only size criteria are used. (b) Axial PET scan shows prominent FDG uptake in the corresponding station 7 (arrowhead) and station 8 (arrow) lymph nodes, a finding that suggests metastasis. Lymph node metastasis was proved at pathologic analysis.

 

Figure 5
View larger version (108K):

[in a new window]
  		Figure 5a.  Station 12 lymph node metastases in a 65-year-old man with stomach cancer. (a) Axial CT scan demonstrates an enlarged lymph node (arrowhead) in the hepatoduodenal ligament adjacent to the proper hepatic artery (arrow). (b, c) Axial (b) and coronal (c) PET scans show the lymph node (arrow) with increased FDG uptake.

 

Figure 5
View larger version (84K):

[in a new window]
  		Figure 5b.  Station 12 lymph node metastases in a 65-year-old man with stomach cancer. (a) Axial CT scan demonstrates an enlarged lymph node (arrowhead) in the hepatoduodenal ligament adjacent to the proper hepatic artery (arrow). (b, c) Axial (b) and coronal (c) PET scans show the lymph node (arrow) with increased FDG uptake.

 

Figure 5
View larger version (87K):

[in a new window]
  		Figure 5c.  Station 12 lymph node metastases in a 65-year-old man with stomach cancer. (a) Axial CT scan demonstrates an enlarged lymph node (arrowhead) in the hepatoduodenal ligament adjacent to the proper hepatic artery (arrow). (b, c) Axial (b) and coronal (c) PET scans show the lymph node (arrow) with increased FDG uptake.

 

Figure 6
View larger version (112K):

[in a new window]
  		Figure 6a.  Multiple station 13 and 14 lymph node metastases in a 52-year-old man with stomach cancer. (a) Axial CT scan demonstrates conglomerated station 13 lymph node metastases (black arrowheads) on the posterior surface of the pancreatic head (black arrow) and station 14 metastasis (white arrowheads) along the superior mesenteric vessel (white arrow). (b, c) Axial (b) and coronal (c) PET scans show prominent FDG uptake in the corresponding station 13 (black arrowheads in b, black arrow in c) and station 14 (white arrowheads in b, white arrow in c) lymph nodes.

 

Figure 6
View larger version (90K):

[in a new window]
  		Figure 6b.  Multiple station 13 and 14 lymph node metastases in a 52-year-old man with stomach cancer. (a) Axial CT scan demonstrates conglomerated station 13 lymph node metastases (black arrowheads) on the posterior surface of the pancreatic head (black arrow) and station 14 metastasis (white arrowheads) along the superior mesenteric vessel (white arrow). (b, c) Axial (b) and coronal (c) PET scans show prominent FDG uptake in the corresponding station 13 (black arrowheads in b, black arrow in c) and station 14 (white arrowheads in b, white arrow in c) lymph nodes.

 

Figure 6
View larger version (105K):

[in a new window]
  		Figure 6c.  Multiple station 13 and 14 lymph node metastases in a 52-year-old man with stomach cancer. (a) Axial CT scan demonstrates conglomerated station 13 lymph node metastases (black arrowheads) on the posterior surface of the pancreatic head (black arrow) and station 14 metastasis (white arrowheads) along the superior mesenteric vessel (white arrow). (b, c) Axial (b) and coronal (c) PET scans show prominent FDG uptake in the corresponding station 13 (black arrowheads in b, black arrow in c) and station 14 (white arrowheads in b, white arrow in c) lymph nodes.

 

Figure 7
View larger version (194K):

[in a new window]
  		Figure 7a.  Station 16 lymph node metastasis in a 55-year-old man with stomach cancer. (a) Coronal reformatted CT image demonstrates a necrotic enlarged lymph node (arrow) around the abdominal aorta. (b) Coronal PET scan shows the lymph node (arrow) with increased FDG uptake.

 

Figure 7
View larger version (134K):

[in a new window]
  		Figure 7b.  Station 16 lymph node metastasis in a 55-year-old man with stomach cancer. (a) Coronal reformatted CT image demonstrates a necrotic enlarged lymph node (arrow) around the abdominal aorta. (b) Coronal PET scan shows the lymph node (arrow) with increased FDG uptake.

 

Figure 8
View larger version (125K):

[in a new window]
  		Figure 8a.  Multiple hepatic metastases in a 58-year-old man with stomach cancer. (a) Portal venous phase CT scan shows multiple metastatic nodules in both hepatic lobes. (b) Axial PET scan shows multiple nodules with prominent FDG uptake in the liver.

 

Figure 8
View larger version (95K):

[in a new window]
  		Figure 8b.  Multiple hepatic metastases in a 58-year-old man with stomach cancer. (a) Portal venous phase CT scan shows multiple metastatic nodules in both hepatic lobes. (b) Axial PET scan shows multiple nodules with prominent FDG uptake in the liver.

 

Figure 9
View larger version (111K):

[in a new window]
  		Figure 9a.  Small hepatic metastases in a 54-year-old man with stomach cancer. (a) Portal venous phase CT scans show four metastatic nodules (arrowheads), none of which is easily discernible. (b) Axial PET scans more clearly depict the nodules (arrowheads). (c) Axial superparamagnetic iron oxide–enhanced gradient-recalled echo T2*-weighted magnetic resonance images (repetition time msec/echo time msec = 120/10, 30° flip angle) help confirm the presence of all four metastatic nodules (arrowheads).

 

Figure 9
View larger version (82K):

[in a new window]
  		Figure 9b.  Small hepatic metastases in a 54-year-old man with stomach cancer. (a) Portal venous phase CT scans show four metastatic nodules (arrowheads), none of which is easily discernible. (b) Axial PET scans more clearly depict the nodules (arrowheads). (c) Axial superparamagnetic iron oxide–enhanced gradient-recalled echo T2*-weighted magnetic resonance images (repetition time msec/echo time msec = 120/10, 30° flip angle) help confirm the presence of all four metastatic nodules (arrowheads).

 

Figure 9
View larger version (130K):

[in a new window]
  		Figure 9c.  Small hepatic metastases in a 54-year-old man with stomach cancer. (a) Portal venous phase CT scans show four metastatic nodules (arrowheads), none of which is easily discernible. (b) Axial PET scans more clearly depict the nodules (arrowheads). (c) Axial superparamagnetic iron oxide–enhanced gradient-recalled echo T2*-weighted magnetic resonance images (repetition time msec/echo time msec = 120/10, 30° flip angle) help confirm the presence of all four metastatic nodules (arrowheads).

 

Figure 10
View larger version (107K):

[in a new window]
  		Figure 10a.  Krukenberg tumor in a 34-year-old woman with stomach cancer. (a) CT scan shows a mixed cystic-solid tumor (arrows) in the pelvis. (b) Axial PET scan demonstrates the tumor (arrows) with increased FDG uptake. Metastatic involvement of the ovary was proved at histologic analysis of the gross specimen.

 

Figure 10
View larger version (63K):

[in a new window]
  		Figure 10b.  Krukenberg tumor in a 34-year-old woman with stomach cancer. (a) CT scan shows a mixed cystic-solid tumor (arrows) in the pelvis. (b) Axial PET scan demonstrates the tumor (arrows) with increased FDG uptake. Metastatic involvement of the ovary was proved at histologic analysis of the gross specimen.

 

Figure 11
View larger version (82K):

[in a new window]
  		Figure 11a.  Supraclavicular lymph node metastasis in a 44-year-old woman with stomach cancer. (a) Chest CT scan shows bilateral supraclavicular lymph nodes (arrows) less than 1 cm in diameter. (b, c) Axial (b) and coronal (c) PET scans show the lymph nodes (arrows) with increased FDG uptake. Metastatic involvement was confirmed at needle aspiration biopsy.

 

Figure 11
View larger version (43K):

[in a new window]
  		Figure 11b.  Supraclavicular lymph node metastasis in a 44-year-old woman with stomach cancer. (a) Chest CT scan shows bilateral supraclavicular lymph nodes (arrows) less than 1 cm in diameter. (b, c) Axial (b) and coronal (c) PET scans show the lymph nodes (arrows) with increased FDG uptake. Metastatic involvement was confirmed at needle aspiration biopsy.

 

Figure 11
View larger version (124K):

[in a new window]
  		Figure 11c.  Supraclavicular lymph node metastasis in a 44-year-old woman with stomach cancer. (a) Chest CT scan shows bilateral supraclavicular lymph nodes (arrows) less than 1 cm in diameter. (b, c) Axial (b) and coronal (c) PET scans show the lymph nodes (arrows) with increased FDG uptake. Metastatic involvement was confirmed at needle aspiration biopsy.

 

Figure 12
View larger version (107K):

[in a new window]
  		Figure 12a.  Peritoneal metastasis in a 38-year-old man with stomach cancer. (a) CT scan shows small metastatic nodules in the omentum (arrows) and enhanced peritoneal thickening (arrowheads). Peritoneal metastasis was confirmed at histologic analysis of ascitic fluid obtained with fine-needle aspiration. (b) Coronal PET scan shows diffuse FDG uptake throughout the entire abdomen and pelvis. The uptake obscures normal, discrete visceral outlines (arrows).

 

Figure 12
View larger version (123K):

[in a new window]
  		Figure 12b.  Peritoneal metastasis in a 38-year-old man with stomach cancer. (a) CT scan shows small metastatic nodules in the omentum (arrows) and enhanced peritoneal thickening (arrowheads). Peritoneal metastasis was confirmed at histologic analysis of ascitic fluid obtained with fine-needle aspiration. (b) Coronal PET scan shows diffuse FDG uptake throughout the entire abdomen and pelvis. The uptake obscures normal, discrete visceral outlines (arrows).

 

Figure 13
View larger version (111K):

[in a new window]
  		Figure 13a.  Peritoneal metastasis in a 34-year-old woman with stomach cancer. (a) Axial contrast material–enhanced CT scan shows a peritoneal implant (arrows) in the left pelvic peritoneum. (b) Axial PET scan shows a discrete focus of increased FDG uptake (arrow) in the same location.

 

Figure 13
View larger version (61K):

[in a new window]
  		Figure 13b.  Peritoneal metastasis in a 34-year-old woman with stomach cancer. (a) Axial contrast material–enhanced CT scan shows a peritoneal implant (arrows) in the left pelvic peritoneum. (b) Axial PET scan shows a discrete focus of increased FDG uptake (arrow) in the same location.

 

Figure 14
View larger version (186K):

[in a new window]
  		Figure 14a.  Peritoneal metastasis from poorly differentiated adenocarcinoma (confirmed at endoscopic biopsy) in a 59-year-old man with stomach cancer. (a) Coronal reformatted CT image shows omental infiltration (arrows). (b) Coronal reformatted CT image demonstrates ascitic fluid (*) and parietal peritoneal thickening (arrows), findings that suggest peritoneal metastasis. (c) Coronal PET scan demonstrates slightly increased bowel uptake in the abdomen without obscuration of visceral outlines. Differentiation between normal physiologic bowel uptake and tumor seeding is difficult.

 

Figure 14
View larger version (182K):

[in a new window]
  		Figure 14b.  Peritoneal metastasis from poorly differentiated adenocarcinoma (confirmed at endoscopic biopsy) in a 59-year-old man with stomach cancer. (a) Coronal reformatted CT image shows omental infiltration (arrows). (b) Coronal reformatted CT image demonstrates ascitic fluid (*) and parietal peritoneal thickening (arrows), findings that suggest peritoneal metastasis. (c) Coronal PET scan demonstrates slightly increased bowel uptake in the abdomen without obscuration of visceral outlines. Differentiation between normal physiologic bowel uptake and tumor seeding is difficult.

 

Figure 14
View larger version (111K):

[in a new window]
  		Figure 14c.  Peritoneal metastasis from poorly differentiated adenocarcinoma (confirmed at endoscopic biopsy) in a 59-year-old man with stomach cancer. (a) Coronal reformatted CT image shows omental infiltration (arrows). (b) Coronal reformatted CT image demonstrates ascitic fluid (*) and parietal peritoneal thickening (arrows), findings that suggest peritoneal metastasis. (c) Coronal PET scan demonstrates slightly increased bowel uptake in the abdomen without obscuration of visceral outlines. Differentiation between normal physiologic bowel uptake and tumor seeding is difficult.

 

Figure 15
View larger version (131K):

[in a new window]
  		Figure 15a.  Local tumor recurrence following subtotal gastrectomy in a 63-year-old man. (a) Axial contrast-enhanced CT scan shows mild gastric wall thickening (arrows) at an anastomotic site. This finding was misinterpreted as a postoperative change (possibly plication-induced fibrotic change or reflux gastritis). (b) Axial PET scan shows prominent increased FDG uptake (arrows) in the anastomotic site. Cancer recurrence was proved at histologic analysis of tissue obtained at endoscopic biopsy.

 

Figure 15
View larger version (102K):

[in a new window]
  		Figure 15b.  Local tumor recurrence following subtotal gastrectomy in a 63-year-old man. (a) Axial contrast-enhanced CT scan shows mild gastric wall thickening (arrows) at an anastomotic site. This finding was misinterpreted as a postoperative change (possibly plication-induced fibrotic change or reflux gastritis). (b) Axial PET scan shows prominent increased FDG uptake (arrows) in the anastomotic site. Cancer recurrence was proved at histologic analysis of tissue obtained at endoscopic biopsy.

 

Figure 16
View larger version (131K):

[in a new window]
  		Figure 16a.  Suspected tumor recurrence in a 44-year-old woman with stomach cancer. (a, b) Axial contrast-enhanced CT scan (a) and PET scan (b) obtained prior to chemotherapy show prominent diffuse gastric wall thickening (arrows in a) with prominent FDG uptake (arrow in b). (c) Follow-up PET scan obtained approximately 5 months after chemotherapy shows markedly decreased FDG uptake in the stomach (arrow). (d) Follow-up CT scan obtained 3 months later demonstrates obstruction of a pyloric stent (arrow), a finding that suggests residual tumor. A radical subtotal gastrectomy was performed for palliation, but no residual tumor was detected in the resected specimen.

 

Figure 16
View larger version (124K):

[in a new window]
  		Figure 16b.  Suspected tumor recurrence in a 44-year-old woman with stomach cancer. (a, b) Axial contrast-enhanced CT scan (a) and PET scan (b) obtained prior to chemotherapy show prominent diffuse gastric wall thickening (arrows in a) with prominent FDG uptake (arrow in b). (c) Follow-up PET scan obtained approximately 5 months after chemotherapy shows markedly decreased FDG uptake in the stomach (arrow). (d) Follow-up CT scan obtained 3 months later demonstrates obstruction of a pyloric stent (arrow), a finding that suggests residual tumor. A radical subtotal gastrectomy was performed for palliation, but no residual tumor was detected in the resected specimen.

 

Figure 16
View larger version (112K):

[in a new window]
  		Figure 16c.  Suspected tumor recurrence in a 44-year-old woman with stomach cancer. (a, b) Axial contrast-enhanced CT scan (a) and PET scan (b) obtained prior to chemotherapy show prominent diffuse gastric wall thickening (arrows in a) with prominent FDG uptake (arrow in b). (c) Follow-up PET scan obtained approximately 5 months after chemotherapy shows markedly decreased FDG uptake in the stomach (arrow). (d) Follow-up CT scan obtained 3 months later demonstrates obstruction of a pyloric stent (arrow), a finding that suggests residual tumor. A radical subtotal gastrectomy was performed for palliation, but no residual tumor was detected in the resected specimen.

 

Figure 16
View larger version (125K):

[in a new window]
  		Figure 16d.  Suspected tumor recurrence in a 44-year-old woman with stomach cancer. (a, b) Axial contrast-enhanced CT scan (a) and PET scan (b) obtained prior to chemotherapy show prominent diffuse gastric wall thickening (arrows in a) with prominent FDG uptake (arrow in b). (c) Follow-up PET scan obtained approximately 5 months after chemotherapy shows markedly decreased FDG uptake in the stomach (arrow). (d) Follow-up CT scan obtained 3 months later demonstrates obstruction of a pyloric stent (arrow), a finding that suggests residual tumor. A radical subtotal gastrectomy was performed for palliation, but no residual tumor was detected in the resected specimen.

 




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
RADIOGRAPHICS RADIOLOGY RSNA JOURNALS ONLINE
Copyright © 2006 by the Radiological Society of North America.