title: Fluorodeoxyglucose-positron emission tomography in adenocarcinomas of the distal esophagus and cardia.
abstract: Adenocarcinomas of the esophagogastric junction (AEG) are now recognized as a separate tumor entity with increasing incidence. The aim of the present study was to evaluate whether positron emission tomography (PET) using the glucose analog F-18-fluorodeoxyglucose (FDG) can be used for metabolic characterization of this tumor type. Fifty-two patients with histologically proven, locally advanced AEG (distal esophagus, type I: n = 31; cardia, type II: n = 21) were studied by FDG-PET. None of the tumors had been previously treated. Findings of endoscopy (growth type), endoluminal ultrasound (uT, uN), computed tomography (cN, cranio-caudal extent, tumor thickness), histological evaluation (Lauren classification, tumor grade), anatomical classification, and survival were correlated with the results of FDG-PET. There was no correlation between FDG uptake and clinical stage, grade, Lauren classification, or survival. All AEG I tumors were visualized by FDG-PET with high contrast, whereas FDG uptake by five AEG II tumors (24%) did not differ from background activity. In a quantitative analysis, mean FDG uptake of AEG I tumors was 1.6 times higher than that of AEG II tumors ( p = 0.0005). PET can be used to visualize type I adenocarcinomas of the esophagogastric junction (AEG I). In AEG II tumors, however, the use of FDG-PET appears to be limited. The significantly higher FDG uptake of AEG I tumors compared to AEG II tumors suggests that these two tumor types differ in glucose utilization. This finding strengthens the hypothesis that AEG I and AEG II are two different tumor entities.
authors.affiliation: Department of Surgery, Klinikum Rechts der Isar, Technical University Munich, Ismaningerstrasse 22, D-81675 Munich, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Ott
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Weber
authors.forename: Ulrich
authors.initials: U
authors.lastname: Fink
authors.forename: Hermann
authors.initials: H
authors.lastname: Helmberger
authors.forename: Karen
authors.initials: K
authors.lastname: Becker
authors.forename: Hubert J
authors.initials: HJ
authors.lastname: Stein
authors.forename: James
authors.initials: J
authors.lastname: Müller
authors.forename: Markus
authors.initials: M
authors.lastname: Schwaiger
authors.forename: Jörg Rüdiger
authors.initials: JR
authors.lastname: Siewert
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002299:Cardia / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality; D004943:Esophagogastric Junction / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality; D015996:Survival Rate; D014055:Tomography, Emission-Computed
chemical_list: D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18