Diagnostic and Prognostic Value of F18 FDG PET/CT in Assessing Nodal Metastasis in High-Risk GIST Patients | ||||
| Egyptian Journal Nuclear Medicine | ||||
| Volume 30, Issue 1, June 2025, Page 26-40 PDF (461.38 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyjnm.2025.375948.1116 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Esraa Ahmed Elkholy   1; Salwa Abd ElGiad2; Hosna Mohamed Moustafa3; Gihan El-Hennawy 4
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| 1Nuclear Medicine and radiotherapy department, national cancer institute, Cairo University | ||||
| 2nuclear Medicine and Radiotherapy departement, national cancer Institute, Cairo University | ||||
| 3Professor of Nuclear Medicine, Faculty of Medicine, Cairo University. | ||||
| 4Nuclear medicine department , national cancer institute , Cairo university , Egypt | ||||
| Abstract | ||||
| Aim: In order to diagnose nodal metastases and assess the prognosis and response to imatinib mesylate (Gleevec), this study set out to determine the diagnostic and prognostic utility of F18 FDG PET/CT. Materials and Procedures: FDG PET/CT scans were retrospectively evaluated in 159 individuals with pathologically confirmed GIST (77 females, 82 males, mean age: 49.2±12.7). A total of 194 PET/CT tests (57 pre-treatment and 137 follow-up) were performed to analyze nodal lesions throughout imatinib therapy. The criteria of reference were pathological and clinical/radiological follow-up for a period of 13-15 months. Findings The mean age of the 29 patients (18.2%) with lymph node (LN) metastases was 53.2±12.7. Sixty-two percent of the patients had primary stomach disease, and sixty-nine percent had high-risk spindle cell disease. The size ranged from 1 to 8.7 cm, with a mean SUVmax value of 6.7 ± 4.5 and a size of 2.1 cm. Only six patients had isolated nodal metastases, while the other twenty-three patients had multiple and triple sites of metastases (liver and/or peritoneal deposits). There are 89 lymph nodes seen in all, including 17 with mediastinal deposits and 70 with abdomino-pelvic deposits. Compared to 55% of metastatic patients without nodal involvement and only 6.5% of non-metastasized patients, 21 patients (72.4%) in the group with nodal metastases suffer disease progression. (P value <0.001). The mortality rate was not statistically significant, with four of the 29 patients with nodal metastases (13.7%) dying, compared to around 10% and 4.9% for the other metastatic and non-metastasized groups, respectively. (p value ~0.841) In conclusion: With an incidence of 18.2%, lymph node metastases are thought to be a poor prognostic factor for GIST patients, FDG PET/CT appears to be an effective method for detecting lymph nodes and evaluating imatinib therapy response. | ||||
| Keywords | ||||
| FDG PET/CT; nodal metastases; GIST; prognosis | ||||
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