title: Clinical significance of primary lesion FDG uptake for choice between oesophagectomy and endoscopic submucosal dissection for resectable oesophageal squamous cell carcinomas.
abstract: OBJECTIVE
  To correlate primary oesophageal squamous cell carcinoma (SCC) (18)F-fluoro-deoxyglucose (FDG) uptake with pathological factors and examine its significance regarding choice of therapy.
  
  
  METHODS
  We retrospectively examined the factors affecting visible and non-visible FDG uptake in 37 primary lesions in 32 oesophageal SCC patients who underwent PET/CT before oesophagectomy or endoscopic submucosal dissection (ESD). We divided the lesions into pathological depth invasion ≥sm2 oesophagectomy (n = 18) and ≤sm1 ESD (n = 19) indicated groups and compared the diagnostic accuracy of FDG-PET with that of endoscopic ultrasound (EUS) performed for 23 superficial lesions to discriminate between these groups.
  
  
  RESULTS
  There were 17 visible and 20 non-visible lesions. The lesion visibility was significantly higher in the larger (≥40 mm), non-flat type, more deeply invaded, positive vascular invasion (P < 0.001 each), positive nodal metastasis (P = 0.04) and higher Glut-1 score (P = 0.005) tumour groups. When the visible and non-visible lesions indicated a need for oesophagectomy and ESD respectively, the sensitivity, specificity and accuracy of oesophagectomy were 94% (17/18), 100% (19/19) and 97% (36/37) and those of EUS were 75% (3/4), 79% (15/19) and 78% (18/23) respectively.
  
  
  CONCLUSIONS
  Primary lesion FDG visibility can be one of the indicators for choosing between oesophagectomy and ESD for resectable oesophageal SCCs.
authors.affiliation: Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan. toyo.nakajo@dolphin.ocn.ne.jp
authors.forename: Masatoyo
authors.initials: M
authors.lastname: Nakajo
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakajo
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tani
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Kajiya
authors.forename: Shunji
authors.initials: S
authors.lastname: Shimaoka
authors.forename: Akio
authors.initials: A
authors.lastname: Matsuda
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Nioh
authors.forename: Tohru
authors.initials: T
authors.lastname: Nihara
authors.forename: Toyokuni
authors.initials: T
authors.lastname: Suenaga
authors.forename: Sadao
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shirahama
authors.forename: Michiyo
authors.initials: M
authors.lastname: Higashi
authors.forename: Chihaya
authors.initials: C
authors.lastname: Koriyama
mesh_terms: D000368:Aged; D004724:Endoscopy / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000494:pharmacology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18