, Volume 17, Issue 12, pp 3181-3186
Date: 08 Jul 2010

18F-FAMT-PET Is Useful for the Diagnosis of Lymph Node Metastasis in Operable Esophageal Squamous Cell Carcinoma

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Abstract

Background

The role and potential usefulness of positron emission tomography (PET) scanning in certain tumors has been widely investigated in recent years. 18F-FAMT (L-[3-18F]-α-methyltyrosine) is an amino acid tracer for PET. This study investigated whether PET/CT with 18F-FAMT provides additional information for preoperative diagnostic workup of esophageal squamous cell carcinoma compared with that obtained by 18F-FDG (fluorodeoxyglucose) PET or CT.

Methods

PET/CT studies with 18F-FAMT and 18F-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, 18F-FAMT-PET exhibited a sensitivity of 76.2%, whereas the sensitivity for 18F-FDG-PET was 90.5% (P = 0.214). 18F-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, 18F-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 18F 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 18F-FAMT-PET is significantly higher than that of 18F-FDG-PET (P = 0.042) and CT (P = 0.002). 18F-FAMT-PET did not have any false-positive findings compared to those with 18F-FDG-PET.

Conclusions

Our findings suggest that the addition of 18F-FAMT-PET to 18F-FDG-PET and CT would permit more precise staging of esophageal cancer.