title: Clinical significance of ¹⁸F-fluorodeoxyglucose positron emission tomography in superficial esophageal squamous cell carcinoma.
abstract: OBJECTIVE
  To assess the clinical usefulness and significance of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in superficial esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  We examined FDG-PET for 80 consecutive patients with superficial ESCC without neoadjuvant treatment. Fifty-seven patients underwent radical esophagectomy, and 23 patients received endoscopic resection. The FDG uptake index was evaluated with clinicopathological findings, and glucose transporter 1 (Glut-1) expression in primary tumors was examined immunohistochemically.
  
  
  RESULTS
  The FDG uptake in primary tumors correlated with histology, depth of tumor invasion, lymph node metastasis, lymphatic invasion, vascular invasion, and Glut-1 expression. All patients with more than 4.4 maximum standardized uptake value (SUVmax) had deeper invasion of submucosa. Among 16 patients with lymph node metastasis, only two were found to have lymph node metastasis. FDG uptake, depth of tumor invasion, lymph node metastasis, and histology were found to be prognostic factors, and histology was an independent prognostic factor. In FDG uptake-positive patients, depth of tumor invasion and histology were prognostic factors.
  
  
  CONCLUSIONS
  FDG-PET is useful for diagnosing tumors with deeper invasion of submucosa and is helpful in making decisions regarding endoscopic treatment for superficial ESCC. Patients with FDG uptake-positive disease, deeper invasion of submucosa, poorly differentiated tumor, and poor prognosis should receive multimodal treatment.
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka, Kagoshima, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Uchikado
authors.forename: Ken
authors.initials: K
authors.lastname: Sasaki
authors.forename: Itaru
authors.initials: I
authors.lastname: Omoto
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Setoyama
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Tanoue
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Kajiya
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy; D004945:Esophagoscopy; D005260:Female; D019788:Fluorodeoxyglucose F18; D051272:Glucose Transporter Type 1 / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals
chemical_list: D051272:Glucose Transporter Type 1; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18