Gastric cancer and image-derived quantitative parameters: Part 2-a critical review of DCE-MRI and F-18-FDG PET/CT findings

There is yet no consensus on the application of functional imaging and qualitative image interpretation in the management of gastric cancer. In this second part, we will discuss the role of image-derived quantitative parameters from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) in gastric cancer, as both techniques have been shown to be promising and useful tools in the clinical decision making of this disease. We will focus on different aspects including aggressiveness assessment, staging and Lauren type discrimination, prognosis prediction and response evaluation. Although both the number of articles and the patients enrolled in the studies were rather small, there is evidence that quantitative parameters from DCE-MRI such as K-trans, V-e, K-ep and AUC could be promising image-derived surrogate parameters for the management of gastric cancer. Data from F-18-FDG PET/CT studies showed that standardised uptake value (SUV) is significantly associated with the aggressiveness, treatment response and prognosis of this disease. Along with the results from diffusion-weighted MRI and contrast-enhanced multidetector computed tomography presented in Part 1 of this critical review, there are additional image-derived quantitative parameters from DCE-MRI and F-18-FDG PET/CT that hold promise as effective tools in the diagnostic pathway of gastric cancer.