The aim of the study was to evaluate the usefulness of 18F-FLT PET/CT in the detection and differentiation of gastric cancers (GC). 104 consecutive patients (57 cases of adenocarcinoma tubulare (G2 and G3), 17 cases of mucinous adenocarcinoma, 6 cases of undifferentiated carcinoma, 14 cases of adenocarcinoma partim mucocellulare, and 10 cases of end stage gastric cancer) with newly diagnosed advanced gastric cancer were examined with FLT PET/CT. For quantitative and comparative analyses, the maximal standardized uptake value ( ) was calculated for both the tumors and noninvaded gastric wall. Results. There were found, in the group of adenocarcinoma tubulare, 1.5–23.1 ( ), in mucinous adenocarcinoma, 2.3–10.3 ( ), in undifferentiated carcinoma, 3.1–13.6 ( ), in adenocarcinoma partim mucocellulare, 2–25.3 ( ), and, in normal gastric wall, 1.01–2.55 ( ). For the level of 2.6 cut-off value between the normal wall and neoplasm FLT uptake from ROC analysis, all but five gastric cancers showed higher accumulation of FLT than noninfiltrated mucosa. Conclusion. Gastric cancer presents higher accumulation of 18F-FLT than normal, distended gastric mucosa. Significantly higher accumulation was shown in cancers better differentiated and with higher cellular density. 1. Introduction Gastric cancer (GC) is an aggressive neoplasm with very poor prognosis. In Poland, in 2010, a number of 5364 people died (3486 men and 1878 women) due to gastric cancer. During the last 4 decades, both morbidity and mortality have dropped significantly in Poland from the 1st place at the beginning of the 1970s to the 4th most common cancer related death in men and the 7th in females [1]. The treatment of choice for GC is complete tumor resection. Early detection and surgery have improved the results of treatment. However, many patients are still diagnosed with advanced-stage disease. Accurate determination of local invasion, tumor size and location, lymph node involvement, and distant metastases is of great importance in the qualification of patients to adequate treatment. Detection of early-stage GC by 18F-FDG PET is not successful, as FDG uptake is strongly related to tumor size, location, and histopathology, for example, a content of mucus [2, 3]. In 1998, 18F-FLT (FLT)—a new radiotracer with the potential ability to be captured by fast proliferating cells—was reported [4]. The authors found that FLT is accumulated in proliferating tissues by the action of thymidine kinase and is resistant to degradation. In PET, it produces high-contrast images of normal marrow and tumors in human.
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