18F-Deoxyglucose PET for the staging of oesophageal cancer

Summary

Aim: Evaluation of the influence of histopathologic sub-types and grading of primaries of oesophageal cancer, relative to their size and location, on the uptake of ¹⁸F-deoxyglucose (FDG) as measured by positron emission tomography (PET). Methods: 50 consecutive patients were evaluated. There were four drop-outs due to previous surgical and/or chemotherapeutical treatments and thus in 46 patients (28 squamous cell carcinomas and 18 adenocarcinomas) a pretherapeutic PET evalution of the primary including a standard uptake value (SUV) was obtained. In 42 cases data on tumour grading were available also. Results: Squamous cell carcinomas (SCC) were in 7/13/8 cases located in the proximal, medial and distal part of the oesophagus, respectively the grading was Gx in 3, G 2 in 12, G2-3 in 7, and G3 in 6 cases. The SUV_max showed a mean of 6.5 ± 2.8 (range 1.7-13.5). Adenocarcinomas (ACA) were located in the medial oesophagus in two cases and otherwise in its distal parts. Grading was Gx in one, G2 in 4, G2-3 in 3, G3 in 3, G3-4 in 3, and G4 in one case. The mean SUV_max was 5.2 ± 3.2 (range 1-13.6) and this was not significantly different from the SCC. Concerning the tumour grading there was a slight, statistically not relevant trend towards higher SUV_max in more dedifferentiated cancer. Discussion: SCC and ACA of the oesophagus show no relevant differences in the FDG-uptake. While there was a significant variability of tumour uptake in the overall study group, a correlation of SUV and tumour grading was not found.

Zusammenfassung

Ziel: Untersuchung zum Einfluss des histopathologischen Subtyps, des Tumorgradings sowie der Tumorlokalisation und Größe von Ösophaguskarzinomen auf das Speicherverhalten von ¹⁸F-Desoxyglukose (FDG) in der Positronenemissionstomographie (PET). Methode: 50 konsekutive Patienten wurden ausgewertet, vier wurden wegen einer operativen und/oder chemotherapeutischen Vorbehandlung ausgeschlossen. Bei 46 Patienten (28 Plattenepithelkarzinome, 18 Adenokarzinome) konnte ein prätherapeutischer SUV_max. des Primarius erhoben werden. In 42 Fällen lag ein Tumorgrading vor. Ergebnisse: Die Plattenepithelkarzinome (PLE) waren in 7/13/8 Fällen im proximalen, mittleren bzw. distalen Ösophagusabschnitt lokalisiert. Das Grading lautete Gx in 3, G2 in 12, G2-3 in 7 und G3 in 6 Fällen. Der SUV_max lag im Mittel bei 6,5 ± 2,8 (Spannweite 1,7-13,5). Adenokarzinome (ACA) lagen in 2 Fällen im mittleren, sonst im distalen Drittel der Speiseröhre. Das Grading lautete Gx in 1, G2 in 4, G2-3 in 3, G3 in 3, G3-4 in 3 und G4 in 1 Fall. Der SUV_max lag im Mittel bei 5,2 ± 3,2 (Spannweite 1-13,6) und unterschied sich damit nicht signifikant vom Ergebnis der PLE. Hinsichtlich des Tumorgradings ergab sich bei PLE und ACA ein statistisch nicht relevanter Trend hin zu höheren SUV bei wenig oder gering differenzierten Karzinomen. Schlussfolgerung: PLE und ACA der Speiseröhre zeigen keine signifikanten Unterschiede im Speicherverhalten der ¹⁸F-Desoxyglukose. Bei erheblicher Variabilität des Tumor-Uptakes konnte ebenfalls keine Korrelation zum Tumorgrading gefunden werden.

Keywords

PET - oesophageal cancer - tumour grading

Schlüsselwörter

PET - Ösophaguskarzinom - Grading

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