PT  - JOURNAL ARTICLE
AU  - van Westreenen, Henderik L.
AU  - Cobben, David C.P.
AU  - Jager, Pieter L.
AU  - van Dullemen, Hendrik M.
AU  - Wesseling, Jelle
AU  - Elsinga, Philip H.
AU  - Plukker, John Th.
TI  - Comparison of <sup>18</sup>F-FLT PET and <sup>18</sup>F-FDG PET in Esophageal Cancer
DP  - 2005 Mar 01
TA  - Journal of Nuclear Medicine
PG  - 400--404
VI  - 46
IP  - 3
4099  - http://jnm.snmjournals.org/content/46/3/400.short
4100  - http://jnm.snmjournals.org/content/46/3/400.full
SO  - J Nucl Med2005 Mar 01; 46
AB  - 18F-FDG PET has gained acceptance for staging of esophageal cancer. However, FDG is not tumor specific and false-positive results may occur by accumulation of FDG in benign tissue. The tracer 18F-fluoro-3′-deoxy-3′-l-fluorothymidine (18F-FLT) might not have these drawbacks. The aim of this study was to investigate the feasibility of 18F-FLT PET for the detection and staging of esophageal cancer and to compare 18F-FLT PET with 18F-FDG PET. Furthermore, the correlation between 18F-FLT and 18F-FDG uptake and proliferation of the tumor was investigated. Methods: Ten patients with biopsy-proven cancer of the esophagus or gastroesophageal junction were staged with CT, endoscopic ultrasonography, and ultrasound of the neck. In addition, all patients underwent a whole-body 18F-FLT PET and 18F-FDG PET. Standardized uptake values were compared with proliferation expressed by Ki-67 positivity. Results: 18F-FDG PET was able to detect all esophageal cancers, whereas 18F-FLT PET visualized the tumor in 8 of 10 patients. Both 18F-FDG PET and 18F-FLT PET detected lymph node metastases in 2 of 8 patients. 18F-FDG PET detected 1 cervical lymph node that was missed on 18F-FLT PET, whereas 18F-FDG PET showed uptake in benign lesions in 2 patients. The uptake of 18F-FDG (median standardized uptake value [SUVmean], 6.0) was significantly higher than 18F-FLT (median SUVmean, 3.4). Neither 18F-FDG maximum SUV (SUVmax) nor 18F-FLT SUVmax correlated with Ki-67 expression in the linear regression analysis. Conclusion: In this study, uptake of 18F-FDG in esophageal cancer is significantly higher compared with 18F-FLT uptake. 18F-FLT scans show more false-negative findings and fewer false-positive findings than do 18F-FDG scans. Uptake of 18F-FDG or 18F-FLT did not correlate with proliferation.