Prognostic Importance of Volumetric Data from Pretreatment Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/ Computed Tomography in Gastric Adenocarcinoma: Retrospective Observational Study Mide Adenokarsinom Tanılı Hastalarda Tedavi Öncesi Flor-18-Florodeoksiglukoz Pozitron Emisyon Tomografisi/ Bilgisayarlı Tomografi Volümetrik Parametrelerinin Prognostik Değeri: Retrospektif Gözlemsel Araştırma
Turkiye Klinikleri Journal of Medical Sciences, vol.46, no.2, pp.187-195, 2026 (Scopus, TRDizin)
- Publication Type: Article / Article
- Volume: 46 Issue: 2
- Publication Date: 2026
- Doi Number: 10.5336/medsci.2025-113774
- Journal Name: Turkiye Klinikleri Journal of Medical Sciences
- Journal Indexes: Scopus, Central & Eastern European Academic Source (CEEAS), CINAHL, EMBASE, TR DİZİN (ULAKBİM), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Page Numbers: pp.187-195
- Keywords: Gastric cancer, positron emission tomography/ computed tomography, prognosis, standardized uptake value, volumetric
- Open Archive Collection: AVESIS Open Access Collection
- Eskisehir Osmangazi University Affiliated: Yes
Abstract
Objective: Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) volumetric parameters have been established to quantify the metabolic activity and 3-dimensional volumetric burden of the entire tumor. However, data on their application in gastric cancer remain limited. This study aimed to evaluate the prognostic significance of 18F-FDG PET/CT volumetric parameters in patients with primary gastric adenocarcinoma (GAC). Material and Methods: Maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary gastric lesion were calculated in 52 GAC patients. The prognostic impact of these parameters and the presence of distant or lymph node metastasis was explored using Kaplan-Meier and Cox regression analyses. Results: No correlation was found between SUVmax (p=0.99), MTV (p=0.92), TLG (p=0.32), and overall survival (OS). OS was significantly influenced by distant metastasis (p=0.003); however, no statistically significant correlation was identified despite patients with distant metastasis demonstrating elevated volumetric values. No relationship was found with the presence of metastatic lymph nodes (hazard ratio 0.507, 95% confidence interval 0.24-1.05, p=0.70). Operable patients exhibited reduced MTV and TLG values of the primary tumor compared to non-operable patients (p=0.071 and 0.046, respectively). Patients eligible for surgery had longer survival periods. Conclusion: The analysis did not reveal any significant volumetric prognostic variables. The presence of distant metastases had a significant impact on OS. However, positive FDG PET-CT lymph node status did not reduce survival. The significant relationship between the TLG value and operability suggests that the TLG value may reflect tumor behavior.