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Improving Evaluation of Primary Gastric Malignancies by Distending the Stomach with Milk Immediately Before 18F-FDG PET Scanning

Zhaohui Zhu, Fang Li, Yilei Mao, Wuying Cheng, Xin Cheng and Yonghong Dang
Journal of Nuclear Medicine Technology March 2008, 36 (1) 25-29; DOI: https://doi.org/10.2967/jnmt.107.044081

Article Figures & Data

Figures

  • FIGURE 1. 
    FIGURE 1. 

    Comparison of empty-stomach and distended-stomach PET studies from same patient. Patient (F, 57 y) underwent serial follow-up of cervical carcinoma of uterus after curative surgical removal and radiotherapy. Interval between 2 studies was 7 mo. Stomach (arrow) showing moderate to intense 18F-FDG uptake in empty-stomach study (A, coronal images) changed to “hollow” region in distended-stomach study (B, coronal images). Note that heart, with intense uptake under empty-stomach condition, did not show prominent uptake after gastric distention with milk.

  • FIGURE 2. 
    FIGURE 2. 

    Comparison of empty-stomach and distended-stomach PET scans in 2 patients with moderately to poorly differentiated adenocarcinomas at antrum of stomach. First patient (M, 90 y) underwent empty-stomach PET scan. Coronal (a) and transaxial (b) images showed intense uptake in whole stomach (arrow), which obscured lesion located at antrum. Second patient (M, 62 y) underwent distended-stomach PET scan. On coronal (c) and transaxial (d) images, lesion (arrow) was clearly outlined, and normal gastric wall was distended.

Tables

  • TABLE 1

    Groups and Diagnoses of Patients

    Groups and diagnosesNo. of patients
    Group 1: serial studies under both conditions (distended stomach [n = 72] and empty stomach [n = 79])43
     Lung cancer18
     Non-Hodgkin's lymphoma6
     Ovarian cancer6
     Breast cancer2
     Cervical cancer of uterus2
     Other9
    Group 2: gastric malignancies
     Underwent distended-stomach PET study24
      Adenocarcinoma, not mucinous15
      Adenocarcinoma, mucinous1
      Signet-ring cell carcinoma5
      Non-Hodgkin's lymphoma3
     Underwent empty-stomach PET study17
      Adenocarcinoma, not mucinous11
      Adenocarcinoma, mucinous2
      Signet-ring cell carcinoma3
      Non-Hodgkin's lymphoma1
  • TABLE 2

    SUVs in Gastric Wall, Heart, Mediastinum, and Liver in Same Patient According to Scan Condition

    Mean ± SD SUV in:
    Organ or tissueEmpty stomach (n = 43)Stomach distended with milk (n = 43)FP
    Gastric wall2.21 ± 0.580.93 ± 0.32184.470.00
    Heart3.13 ± 1.852.71 ± 1.542.000.16
    Mediastinum1.38 ± 0.231.36 ± 0.220.470.50
    Liver1.85 ± 0.301.82 ± 0.290.480.49
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