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Clinical significance of primary lesion FDG uptake for choice between oesophagectomy and endoscopic submucosal dissection for resectable oesophageal squamous cell carcinomas

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Abstract

Objectives

To correlate primary oesophageal squamous cell carcinoma (SCC) 18F-fluoro-deoxyglucose (FDG) uptake with pathological factors and examine its significance regarding choice of therapy.

Methods

We retrospectively examined the factors affecting visible and non-visible FDG uptake in 37 primary lesions in 32 oesophageal SCC patients who underwent PET/CT before oesophagectomy or endoscopic submucosal dissection (ESD). We divided the lesions into pathological depth invasion ≥sm2 oesophagectomy (n = 18) and ≤sm1 ESD (n = 19) indicated groups and compared the diagnostic accuracy of FDG-PET with that of endoscopic ultrasound (EUS) performed for 23 superficial lesions to discriminate between these groups.

Results

There were 17 visible and 20 non-visible lesions. The lesion visibility was significantly higher in the larger (≥40 mm), non-flat type, more deeply invaded, positive vascular invasion (P < 0.001 each), positive nodal metastasis (P = 0.04) and higher Glut-1 score (P = 0.005) tumour groups. When the visible and non-visible lesions indicated a need for oesophagectomy and ESD respectively, the sensitivity, specificity and accuracy of oesophagectomy were 94% (17/18), 100% (19/19) and 97% (36/37) and those of EUS were 75% (3/4), 79% (15/19) and 78% (18/23) respectively.

Conclusions

Primary lesion FDG visibility can be one of the indicators for choosing between oesophagectomy and ESD for resectable oesophageal SCCs.

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Authors and Affiliations

  1. Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Masatoyo Nakajo & Masayuki Nakajo

  2. Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan

    Masatoyo Nakajo, Atsushi Tani & Yoriko Kajiya

  3. Department of Gastroentenology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan

    Shunji Shimaoka, Akio Matsuda, Tatsuyuki Nioh & Tohru Nihara

  4. Department of Surgery, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan

    Toyokuni Suenaga

  5. Department of Pathology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan

    Sadao Tanaka

  6. Department of Pathology, Imakiire General Hospital, 4-16 Shimotatsuo, Kagoshima, 892-8502, Japan

    Hiroshi Shirahama

  7. Department of Human Pathology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Michiyo Higashi

  8. Department of Epidemiology and Preventive Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Chihaya Koriyama

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  1. Masatoyo Nakajo
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Correspondence to Masatoyo Nakajo.

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Nakajo, M., Nakajo, M., Tani, A. et al. Clinical significance of primary lesion FDG uptake for choice between oesophagectomy and endoscopic submucosal dissection for resectable oesophageal squamous cell carcinomas. Eur Radiol 21, 2396–2407 (2011). https://doi.org/10.1007/s00330-011-2196-1

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  • DOI: https://doi.org/10.1007/s00330-011-2196-1

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