World Journal of Surgery

, Volume 27, Issue 9, pp 1035–1039

Fluorodeoxyglucose-Positron Emission Tomography in Adenocarcinomas of the Distal Esophagus and Cardia

  • Katja Ott
  • Wolfgang A. Weber
  • Ulrich Fink
  • Hermann Helmberger
  • Karen Becker
  • Hubert J. Stein
  • James Müller
  • Markus Schwaiger
  • Jörg Rüdiger Siewert
World Progress in Surgery

Abstract

Adenocarcinomas of the esophagogastric junction (AEG) are now recognized as a separate tumor entity with increasing incidence. The aim of the present study was to evaluate whether positron emission tomography (PET) using the glucose analog F-18-fluorodeoxyglucose (FDG) can be used for metabolic characterization of this tumor type. Fifty-two patients with histologically proven, locally advanced AEG (distal esophagus, type I: n = 31; cardia, type II: n = 21) were studied by FDG-PET. None of the tumors had been previously treated. Findings of endoscopy (growth type), endoluminal ultrasound (uT, uN), computed tomography (cN, cranio-caudal extent, tumor thickness), histological evaluation (Lauren classification, tumor grade), anatomical classification, and survival were correlated with the results of FDG-PET. There was no correlation between FDG uptake and clinical stage, grade, Lauren classification, or survival. All AEG I tumors were visualized by FDG-PET with high contrast, whereas FDG uptake by five AEG II tumors (24%) did not differ from background activity. In a quantitative analysis, mean FDG uptake of AEG I tumors was 1.6 times higher than that of AEG II tumors (p = 0.0005). PET can be used to visualize type I adenocarcinomas of the esophagogastric junction (AEG I). In AEG II tumors, however, the use of FDG-PET appears to be limited. The significantly higher FDG uptake of AEG I tumors compared to AEG II tumors suggests that these two tumor types differ in glucose utilization. This finding strengthens the hypothesis that AEG I and AEG II are two different tumor entities.

References

  1. 1.
    Warburg, O 1930The Metabolism of TumorsConstableLondonGoogle Scholar
  2. 2.
    Fischman, AJ, Alpert, NM 1993FDG-PET in oncology: There‘s more to it than looking at picturesJ. Nucl. Med.34611Google Scholar
  3. 3.
    Rigo, P, Paulus, P, Kaschten, BJ,  et al. 1996Oncological applications of positron emission tomography with fluorine-18 fluorodesoxyglucoseEur. J. Nucl. Med.2316411674Google Scholar
  4. 4.
    Prôuer, H, Weber, W, Römer, W,  et al. 1998Evaluation of pulmonary nodules by positron emission tomography using the glucose analogue fluorine-18-fluorodeoxyglucose (FDG). A controlled prospective study in 50 patientsBr. J. Surg.8515061511CrossRefPubMedGoogle Scholar
  5. 5.
    Wahl, RL, Cody, RL, Hutchins, G,  et al. 1991Primary and metastatic breast carcinoma: initial clinical evaluation with PET with the radiolabeled glucose analogue 2-[F-18]-fluoro-2-deoxy-D-glucoseRadiology179765770PubMedGoogle Scholar
  6. 6.
    Moog, F, Bangerter, M, Kotzerke, J,  et al. 199818-F-fluorodeoxyglucose-positron emission tomography as a new approach to detect lymphomatous bone marrowJ. Clin. Oncol.16603609Google Scholar
  7. 7.
    Römer, W, Hanauske, AR, Ziegeler, S,  et al. 1998Positron emission tomography in non-Hodgkin lymphoma: assessment of chemotherapy with fluorodeoxyglucoseBlood9144644471PubMedGoogle Scholar
  8. 8.
    Lindholm, P, Leskinen-Kallio, S, Minn, H,  et al. 1993Comparison of fluorine-18-fluorodeoxyglucose and carbon-11-methionine in head and neck cancerJ. Nucl. Med.3417111716Google Scholar
  9. 9.
    Jones, DN, McCowage, GB, Sostman, HD,  et al. 1996Monitoring of neoadjuvant therapy response of soft-tissue and musculoskeletal sarcoma using fluorine-18-FDG PETJ. Nucl. Med.3714381444Google Scholar
  10. 10.
    Lai, DTM, Fulham, M, Stephen, MS,  et al. 1996The role of whole-body positron emission tomography with [18F] fluorodeoxyglucose in identifying operable colorectal cancer metastases to the liverArch. Surg.131703707Google Scholar
  11. 11.
    Findlay, M, Young, H, Cunningham, H,  et al. 1996Noninvasive monitoring of tumor metabolism using fluorodeoxyglucose and positron emission tomography in colorectal cancer liver metastasis: correlation with tumor response to fluorouracilJ. Clin. Oncol.14700708Google Scholar
  12. 12.
    Hofer, C, Laubenbacher, C, Block, T,  et al. 1999Fluorine-18-fluorodeoxyglucose positron emission tomography is useless for the detection of local recurrence after radical prostatectomyEur. Urol.363135Google Scholar
  13. 13.
    Vansteenkiste, JF, Stroobants, SG, Dupont, PJ,  et al. 1999Prognostic importance of the standardized uptake value on (18)F-fluoro-2-deoxy-glucose-positron emission tomography scan in non-small-cell lung cancer: an analysis of 125 cases. Leuven Lung Cancer GroupJ. Clin. Oncol.1732013206Google Scholar
  14. 14.
    Oshida, M, Uno, K, Suzuki, M,  et al. 1998Predicting the prognoses of breast carcinoma patients with positron emission tomography using 2-deoxy-2-fluoro[18F]-D-glucoseCancer8222272234PubMedGoogle Scholar
  15. 15.
    Couper, GW, McAteer, D, Wallis, F,  et al. 1998Detection of response to chemotherapy using positron emission tomography in patients with oesophageal and gastric cancerBr. J. Surg.8514031406CrossRefPubMedGoogle Scholar
  16. 16.
    McAteer, D, Wallis, F, Couper, G,  et al. 1999Evaluation of 18F-FDG positron emission tomography in gastric and oesophageal carcinomaBr. J. Radiol.72525529PubMedGoogle Scholar
  17. 17.
    Flamen, P, Lerut, A, Cutsem, E,  et al. 2000The utility of positron emission tomography for the diagnosis and staging of recurrent esophageal cancerJ. Thorac. Cardiovasc. Surg.12010851092Google Scholar
  18. 18.
    Flamen, P, Lerut, A, Cutsem, E,  et al. 2000Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinomaJ. Clin. Oncol.1832023210PubMedGoogle Scholar
  19. 19.
    Flanagan, FL, Dehdashti, F, Siegel, BA,  et al. 1997Staging of esophageal cancer with 18F-fluorodeoxyglucose positron emission tomographyAm. J. Roentgenol.168417424Google Scholar
  20. 20.
    Kole, AC, Plukker, JT, Nieweg, OE,  et al. 1998Positron emission tomography for staging of oesophageal and gastroesophageal malignancyBr. J. Cancer78521527Google Scholar
  21. 21.
    Siewert, JR, Stein, HJ 1998Classification of the adenocarcinoma of the oesophagogastric junctionBr. J. Surg.8514571459Google Scholar
  22. 22.
    DiChiro, G, Hatazawa, J, Katz, DA,  et al. 1987Glucose utilisation by intracranial meningiomas as an index of tumor aggressivity and probability of recurrence: a PET studyRadiology165521526Google Scholar
  23. 23.
    Okada, J, Yoshikawa, K, Imazeki, K,  et al. 1991The use of FDG-PET in the detection and management of malignant lymphoma: correlation and uptake with prognosisJ. Nucl. Med.32686691PubMedGoogle Scholar
  24. 24.
    Adler, LP, Blair, HF, Makley, JT,  et al. 1991Noninvasive grading of muscoloskeletal tumors using PETJ. Nucl. Med.3215081512Google Scholar
  25. 25.
    Fukunga, T, Okazumi, S, Koide, Y,  et al. 1998Evaluation of esophageal cancers using fluorine-18-fluorodeoxyglucose PETJ. Nucl. Med.3910021007PubMedGoogle Scholar
  26. 26.
    Wijnhoven, BPL, Siersema, PD, Hop, WCJ,  et al. 1999Adenocarcinomas of the distal esophagus and gastric cardia are one clinical entityBr. J. Surg.86529535Google Scholar
  27. 27.
    Kalish, RJ, Clancy, PE, Orringer, MB,  et al. 1984Clinical, epidemiologic and morphologic comparison between adenocarcinomas arising in Barrett’s esophageal mucosa and in the gastric cardiaGastroenterology86461467Google Scholar
  28. 28.
    Clark, GWB, Smyrk, TC, Burdiles, P,  et al. 1994Is Barrett’s metaplasia the source of adenocarcinomas of the cardiaArch. Surg.129609614Google Scholar
  29. 29.
    Schneider PM, Schweighart P, Stöltzing O et al. (1997) “Molecular evidence that cancer of the gastric cardia is different from Barrett’s cancer and related to proximal third gastric cancer” In: Siewart, JR, Roder, JD (editors), 2nd International Gastric Cancer Congress, Book of Abstracts 6:Abstract 0549Google Scholar

Copyright information

© Société Internationale de Chirurgie 2003

Authors and Affiliations

  • Katja Ott
    • 1
  • Wolfgang A. Weber
    • 2
  • Ulrich Fink
    • 1
  • Hermann Helmberger
    • 3
  • Karen Becker
    • 4
  • Hubert J. Stein
    • 1
  • James Müller
    • 4
  • Markus Schwaiger
    • 2
  • Jörg Rüdiger Siewert
    • 1
  1. 1.Department of Surgery, Klinikum Rechts der IsarTechnical University MunichMunichGermany
  2. 2.Department of Nuclear Medicine, Klinikum Rechts der IsarTechnical University MunichMunichGermany
  3. 3.Department of Radiology, Klinikum Rechts der IsarTechnical University MunichMunichGermany
  4. 4.Department of Pathology, Klinikum Rechts der IsarTechnical University MunichMunichGermany

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