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Positron emission tomography of esophageal carcinoma using 11 C‐choline and 18 F‐fluorodeoxyglucose
Author(s) -
Kobori Oichiro,
Kirihara Yujiro,
Kosaka Noboru,
Hara Toshihiko
Publication year - 1999
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19991101)86:9<1638::aid-cncr4>3.0.co;2-u
Subject(s) - medicine , mediastinum , positron emission tomography , radiology , lymph node , carcinoma , biopsy , choline , fluorodeoxyglucose , abdomen , lymph , nuclear medicine , esophageal cancer , mediastinal lymph node , lymph node biopsy , esophagus , metastasis , pathology , cancer
BACKGROUND Accurate preoperative staging is an important but difficult problem in determining therapy for patients with esophageal carcinoma. Positron emission tomography (PET) is used with [methyl‐ 11 C]choline ( 11 C‐choline) and 2‐[ 18 F]fluoro‐2‐deoxy‐D‐glucose ( 18 F‐FDG) to detect a variety of malignancies. The authors used PET with both of these agents to detect lymph node metastases in patients with esophageal carcinoma. METHODS Lymph node metastases in 33 patients with biopsy‐proven esophageal carcinoma (16 patients with tumors classified as T1 and 17 patients with tumors classified as T2–4) was examined by PET using 11 C‐choline and 18 F‐FDG, and the accuracy of the results was correlated with pathology findings after surgery. RESULTS 11 C‐choline PET was more effective than 18 F‐FDG PET and computed tomography (CT) in detecting very small metastases localized in the mediastinum. It was ineffective, however, in detecting metastases localized in the upper abdomen, because of the normal uptake of 11 C‐choline in the liver. 18 F‐FDG PET was superior to CT in detecting metastases in the mediastinum and the upper abdomen, whereas 11 C‐choline PET was superior to 18 F‐FDG PET in detecting metastases in the mediastinum. When 11 C‐choline PET and 18 F‐FDG PET were used in combination, they were very effective in evaluating the lymph node status in both the mediastinum and the upper abdomen, and detected 85% of the metastatic lymph nodes (n = 46). CONCLUSIONS In this study, the combination of 11 C‐choline PET and 18 F‐FDG PET was very effective in evaluating the lymph node status of patients with esophageal carcinoma preoperatively. Cancer 1999;86:1638–48. © 1999 American Cancer Society.