The peak-standardized uptake value (P-SUV) by preoperative positron emission tomography-computed tomography (PET-CT) is a useful indicator of lymph node metastasis in gastric cancer.

Background And Objectives: Little data is currently available on the usefulness of peak-standardized uptake value (P-SUV) by positron emission tomography-computed tomography (PET-CT) in gastric cancer. The purpose of the present study was to evaluate the value of PET-CT for the preoperative evaluation of patients with gastric cancer. The aim of this study was to assess the relation of between primary tumor P-SUV, as determined by preoperative PET-CT, and lymph node metastasis in gastric cancer.

Methods: From December 2007 to March 2010, we analyzed the PET-CT of 147 patients that underwent gastrectomy for gastric cancer. P-SUV in PET-CT were measured by single nuclear medicine physician. Statistical analysis was performed to determine relations between clinicopathologic parameters including P-SUV and lymph node metastasis using the chi-square test, the independent t-test, and using logistic regression analysis.

Results: Age, tumor depth, tumor size, and lymph node metastasis were found to be associated with primary tumor P-SUV by PET-CT (P=0.009, <0.001, <0.001, and <0.001, respectively). No association was found between P-SUV and tumor histology or tumor location (P=0.099). Advanced gastric cancer was found to have a higher P-SUV than early gastric cancer, and a higher P-SUV was found to be associated with lymph node metastases by both univariate and multivariate analysis.

Conclusions: P-SUV of primary tumor could be an independent indicator of lymph node metastasis in gastric cancer. Gastric surgeons should pay more attention to the dissection of lymph nodes when primary tumors have higher P-SUV values by PET-CT.