Detection of gastroesophageal reflux esophagitis using 2-fluoro-2-deoxy-d-glucose positron emission tomography.
BACKGROUND
Gastroesophageal reflux disease (GERD) is a common disease and a major upper gastrointestinal problem. The purpose of the present study is to evaluate the use of noninvasive 2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) to detect gastroesophageal reflux esophagitis.


METHODS
This is a retrospective study reviewing 408 healthy check-up subjects (169 females and 239 men), who underwent both FDG-PET and upper gastrointestinal endoscopy during September 2008 to December 2009. Quantitative analysis of FDG uptake in the distal part of the esophagus was performed by calculating the maximum standard uptake value (SUVmax). This indicated the degree of esophagitis. FDG-PET findings were compared with endoscopic (modified version of the Los Angeles classification) diagnoses as the gold standard.


RESULTS
The SUVmax ranged from 1.30 to 3.40 in normal subjects and from 1.30 to 4.00 in subjects with gastroesophageal reflux esophagitis. In the esophagitis group, the SUVmax was 2.13 ± 0.42 in subjects with modified LA grade M, 2.21 ± 0.45 in subjects with LA grade A, and 2.48 ± 0.44 in subjects with LA grade B and C gastroesophageal reflux esophagitis. One-way ANOVA and post-hoc comparison with Bonferroni correction (P value = 0.003) identified statistical differences between the three groups.


CONCLUSIONS
Noninvasive FDG-PET may be useful in the detection and evaluation of various degrees of gastroesophageal reflux esophagitis.
Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan.
Min-Kuei
MK
Tsai
Hueisch-Jy
HJ
Ding
Hsueh-Chou
HC
Lai
Kuo-Yang
KY
Yen
Chia-Ing
CI
Li
Yu-Yi
YY
Lin
Kai-Yuan
KY
Cheng
Keh-Bin
KB
Wang
Chia-Hung
CH
Kao
D004941:Esophagitis / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*
D019788:Fluorodeoxyglucose F18