AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography (18F-FDG PET/CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations. RESULTS: PET/CT was positive in 14 patients (61%) and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients (35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2, true negative in 8 and false negative in 2. Overall, the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negativePET/CT, the f inal diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly, PET/CT revealed true-positive findings in 11 (47.8%) patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in one patient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into their conventional post-operative follow-up program. CONCLUSION: Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients. AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography (18F-FDG PET / CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the period from January 2007 to May 2008, 23 patients who had previous previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET / CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for At least 5 months after PET / CT examinations. RESULTS: PET / CT was positive in 14 patients (61%) and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients (35%) and by clinical follow-up in 15 (65%), PET / CT was true positive in 12 patients, false positive in 2, true negative in 8 and false negative in 2. Overall, the accuracy of PET / CT was 82.6%, the ne The 2 false positive PET / CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negative PET / CT, the f inal diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly, PET / CT revealed true-positive findings in 11 (47.8%) patients who had negative or no definite findings by CT. PET / CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in one patient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET / CT into their conventional post-operative follow-up program. CONCLUSION: Whole body 18F- FDG PET / CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important important on clinical decisions in a substantial portion of patients.