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Background  This study aimed to investigate the prognostic value of volumetric parameters on  18 F- fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in gastric-cancer patients, according to the expression status of c-MET (MET proto-oncogene, receptor tyrosine kinase), which was previously unclear.    Methods  The study included 61 patients with advanced gastric cancer. Data on the baseline  18 F-FDG PET/CT, clinical-pathological information, progression-free survival (PFS), and overall survival (OS) were collected. The maximum standardized uptake value (SUV max ), peak SUV (SUV peak ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of gastric tumors in situ were measured on PET/CT. The expression status of c-MET was recorded based on immunohistochemical staining. Associations between the parameters on PET/CT and patients’ survival outcomes were analyzed in relation to expression status of c-MET.    Results  Patients with positive c-MET expression had significantly shorter PFS (11.5 vs. 17.6 months,  P  = 0.039) and OS (17.0 vs. 24.3 months,  P  = 0.043), and had gastric tumors with a larger MTV (70.8 ± 53.11 vs. 41.1 ± 52.32,  P  = 0.034) and TLG (428.39 ± 442.95 vs. 205.7 ± 354.40,  P  = 0.039), compared with those with negative c-MET expression. However, SUV max  (9.6 ± 7.40 vs. 8.0 ± 4.91,  P  = 0.335) and SUV peak  (7.7 ± 5.99 vs. 6.62 ± 4.08,  P  = 0.438) were similar between these two patient groups. In patients with c-MET-positive tumors, MTV and TLG were independent factors in predicting patient OS after correction by distant metastasis (hazards ratio = 1.014 and 1.002, respectively;  P  = 0.024 and 0.027, respectively), while these associations were not significant in patients with c-MET-negative tumors.    Conclusions  Patients with c-MET-positive gastric cancer had higher MTV and TLG values compared to those with c-MET-negative gastric cancer. In patients with c-MET-positive gastric cancer, volumetric parameters on  18 F-FDG PET/CT have prognostic value for patient overall survival.

Volumetric parameters on 18F-FDG PET/CT predict the survival of patients with gastric cancer associated with their expression status of c-MET