title: 18F-FAMT-PET is useful for the diagnosis of lymph node metastasis in operable esophageal squamous cell carcinoma.
abstract: BACKGROUND
  The role and potential usefulness of positron emission tomography (PET) scanning in certain tumors has been widely investigated in recent years. (18)F-FAMT (L-[3-(18)F]-α-methyltyrosine) is an amino acid tracer for PET. This study investigated whether PET/CT with (18)F-FAMT provides additional information for preoperative diagnostic workup of esophageal squamous cell carcinoma compared with that obtained by (18)F-FDG (fluorodeoxyglucose) PET or CT.
  
  
  METHODS
  PET/CT studies with (18)F-FAMT and (18)F-FDG were performed as a part of the preoperative workup in 21 patients with histologically confirmed esophageal squamous cell carcinoma.
  
  
  RESULTS
  For the detection of primary esophageal cancer, (18)F-FAMT-PET exhibited a sensitivity of 76.2%, whereas the sensitivity for (18)F-FDG-PET was 90.5% (P = 0.214). (18)F-FAMT uptake in primary tumors showed significant correlation with depth of invasion (P = 0.005), lymph node metastasis (P = 0.045), stage (P = 0.031), and lymphatic invasion (P = 0.029). In the evaluation of individual lymph node groups, (18)F-FAMT-PET exhibited 18.2% sensitivity, 100% specificity, 71.9% accuracy, 100% positive predictive value, and 70.0% negative predictive value, compared with 24.2%, 93.7%, 69.8%, 66.6%, and 70.2%, respectively, for (18)F FDG-PET. CT exhibited 39.4% sensitivity, 85.7% specificity, 69.8% accuracy, 59.1% positive predictive value, and 73.0% negative predictive value. The specificity of (18)F-FAMT-PET is significantly higher than that of (18)F-FDG-PET (P = 0.042) and CT (P = 0.002). (18)F-FAMT-PET did not have any false-positive findings compared to those with (18)F-FDG-PET.
  
  
  CONCLUSIONS
  Our findings suggest that the addition of (18)F-FAMT-PET to (18)F-FDG-PET and CT would permit more precise staging of esophageal cancer.
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. msohda@med.gunma-u.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Suzuki
authors.forename: Naritaka
authors.initials: N
authors.lastname: Tanaka
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sano
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakai
authors.forename: Takanori
authors.initials: T
authors.lastname: Inose
authors.forename: Masanobu
authors.initials: M
authors.lastname: Nakajima
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Noboru
authors.initials: N
authors.lastname: Oriuchi
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D019805:alpha-Methyltyrosine
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D019805:alpha-Methyltyrosine