Evaluation of esophageal cancers using fluorine-18-fluorodeoxyglucose PET.
To evaluate glucose metabolism in esophageal cancer, 48 patients were studied using PET with 18F-2-fluoro-2-deoxy-D-glucose (FDG).


METHODS
After transmission scans were obtained, 18F-FDG (148 MBq) was administered intravenously. In 11 patients, a dynamic study was performed to evaluate glucose metabolism. Using the changes of radioactivity in both plasma and tumor, rate constants (k1-k4) defined in the metabolic model for 18F-FDG were calculated. In 48 patients, static PET scans of the tumor (5-min scans) were obtained 60 min after administration. Fluorine-18-FDG activity within each tumor was corrected for physical decay and normalized by dose administration and patient weight to produce a standardized uptake value (SUV).


RESULTS
Both the k3 value (n = 11) reflecting hexokinase activity and SUV (n = 13) were well correlated with hexokinase activity from the resected specimen (p < 0.05). Forty-seven of 48 patients before treatment revealed SUV greater than 2.0, but 10 normal control subjects and 1 esophageal benign tumor revealed less than 2.0 (accuracy rate 98.3%). Although clinicopathological findings did not correlate with SUV, except for two patients with carcinosarcoma, 23 patients with an SUV greater than 7.0 had a poor prognosis compared with 25 patients with SUVs less than 7.0.


CONCLUSIONS
These findings suggest that 18F-FDG PET may be useful in distinguishing malignant tumors from benign lesions and in the preoperative evaluation of the prognostic factor.
Fukunaga
T
T
Second Department of Surgery, Chiba University School of Medicine, Japan.
Okazumi
S
S
Koide
Y
Y
Isono
K
K
Imazeki
K
K
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006593:Hexokinase / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D006593:Hexokinase; D005947:Glucose