EVALUATION OF ESOPHAGEAL CANCERS USING FLUORINE-18-FLUORODEOXYGLUCOSEPET

To evaluate glucose metabolism in esophageal cancer, 48 patients were studied using PET with F-18-2-fluoro-2-deoxy-D-glucose (FDG). Methods: After transmission scans were obtained, F-18-FDG (148 MBq) was admini stered intravenously. In 11 patients, a dynamic study was performed to evaluate glucose metabolism. Using the changes of radioactivity in bo th plasma and tumor, rate constants (k1-k4) defined in the metabolic m odel for F-18-FDG were calculated. In 48 patients, static PET scans of the tumor (5-min scans) were obtained 60 min after administration. Fl uorine-18-FDG activity within each tumor was corrected for physical de cay and normalized by dose administration and patient weight to produc e a standardized uptake Value (SUV). Results: Both the k3 value (n = 1 1) reflecting hexokinase activity and SUV (n = 13) were well correlate d with hexokinase activity from the resected specimen (p < 0.05). Fort y-seven of 48 patients before treatment revealed SUV greater than 2.0, but 10 normal control subjects and 1 esophageal benign tumor revealed less than 2.0 (accuracy rate 98.3%). Although clinicopathological fin dings did not correlate with SUV, except for two patients with carcino sarcoma, 23 patients with an SUV greater than 7.0 had a poor prognosis compared with 25 patients with SUVs less than 7.0. Conclusion: These findings suggest that F-18-FDG PET may be useful in distinguishing mal ignant tumors from benign lesions and in the preoperative evaluation o f the prognostic factor.