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

  • World Progress in Surgery
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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.

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Authors and Affiliations

  1. Department of Surgery, Klinikum Rechts der Isar, Technical University Munich, Ismaningerstrasse 22, D-81675, Munich, Germany

    Katja Ott M.D., Ulrich Fink M.D., Hubert J. Stein M.D. & Jörg Rüdiger Siewert M.D.

  2. Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University Munich, Ismaningerstrasse 22, D-81675, Munich, Germany

    Wolfgang A. Weber M.D. & Markus Schwaiger M.D.

  3. Department of Radiology, Klinikum Rechts der Isar, Technical University Munich, Ismaningerstrasse 22, D-81675, Munich, Germany

    Hermann Helmberger M.D.

  4. Department of Pathology, Klinikum Rechts der Isar, Technical University Munich, Ismaningerstrasse 22, D-81675, Munich, Germany

    Karen Becker M.D. & James Müller M.D.

Authors
  1. Katja Ott M.D.
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  2. Wolfgang A. Weber M.D.
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  3. Ulrich Fink M.D.
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  4. Hermann Helmberger M.D.
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  5. Karen Becker M.D.
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  6. Hubert J. Stein M.D.
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  7. James Müller M.D.
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  8. Markus Schwaiger M.D.
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  9. Jörg Rüdiger Siewert M.D.
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Ott, K., Weber, W., Fink, U. et al. Fluorodeoxyglucose-Positron Emission Tomography in Adenocarcinomas of the Distal Esophagus and Cardia. World J. Surg. 27, 1035–1039 (2003). https://doi.org/10.1007/s00268-003-7058-9

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  • DOI: https://doi.org/10.1007/s00268-003-7058-9

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