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Comparison of Uptake Characteristics and Prognostic Value of 201Tl and 18F-FDG in Esophageal Cancer

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Abstract

Background

Patients with esophageal cancer often undergo 201Tl myocardial imaging for preoperative risk evaluation, thereby providing an excellent opportunity to assess tumor handling of 201Tl. We thus compared the characteristics of 201Tl and 18F-FDG uptake by esophageal cancer and further investigated their prognostic values.

Methods

The study included 100 newly diagnosed esophageal cancer patients who underwent preoperative 201Tl SPECT and 18F-FDG PET exams. Tumor to mediastinal uptake (T/M) ratio and retention index (RI) of 201Tl, tumor 18F-FDG pSUV, tumor size, location, and stage were assessed. Survival analysis was performed for disease-free survival using the Kaplan–Meier method. Cox proportional hazard models were used to determine independent risk factors.

Results

201Tl SPECT and 18F-FDG PET visualized the primary tumor in 85/100 (85.0%) and 91/100 (91.0%) patients, respectively (p = 0.03). There were close correlations between early and delayed 201Tl T/M ratios (r = 0.83, p < 0.0001) and between T/M ratios and 18F-FDG pSUV (r = 0.56 and 0.57, respectively, both p < 0.0001). Both T/M ratios and 18F-FDG pSUV correlated significantly with tumor stage (ρ = 0.45, 0.40, and 0.59, respectively, all p < 0.0001). Survival analysis revealed tumor size, 201Tl negative tumors, 18F-FDG negative tumors, delayed 201Tl T/M ratio, RI, stage, and 18F-FDG pSUV to be significant univariate predictors for disease-free survival. Multivariate survival analysis showed stage (p = 0.02) to be a significant independent prognostic predictor.

Conclusions

In patients with esophageal cancer, assessment of tumor 201Tl uptake, as with 18F-FDG, may provide potentially useful information regarding tumor characteristics.

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References

  1. Enzinger PC, Mayer RJ (2003) Esophageal cancer. N Engl J Med 349:2241–2252

    Article  PubMed  CAS  Google Scholar 

  2. Müller JM, Erasmi H, Stelzner M, et al. (1990) Surgical therapy of esophageal carcinoma. Br J Surg 77:845–857

    Article  PubMed  Google Scholar 

  3. Hofstetter W, Swisher SG, Correa AM, et al. (2002) Treatment outcomes of resected esophageal cancer. Ann Surg 236:376–384

    Article  PubMed  Google Scholar 

  4. Bartels H, Stein HJ, Siewert JR (1998) Preoperative risk analysis and postoperative mortality of oesophagectomy for resectable oesophageal cancer. Br J Surg 85:840–844

    Article  PubMed  CAS  Google Scholar 

  5. Law SYK, Fok M, Wong J (1994) Risk analysis in resection of squamous cell carcinoma of the esophagus. World J Surg 18:339–346

    Article  PubMed  CAS  Google Scholar 

  6. Lund O, Kimose HH, Aagaard MT, et al. (1990) Risk stratification and long-term results after surgical treatment of carcinoma of the thoracic esophagus and cardia. J Thorac Cardiovasc Surg 99:200–209

    PubMed  CAS  Google Scholar 

  7. Sehweil AM, McKillop JH, Milroy R, et al: (1989) Mechanism of Tl-201 uptake in tumors. Eur J Nucl Med 15:376–379

    Article  PubMed  CAS  Google Scholar 

  8. Higashi K, Ueda Y, Sakuma T, et al. (2001) Comparison of [18F]FDG PET and 201Tl SPECT in evaluation of pulmonary nodules. J Nucl Med 42:1489–1496

    PubMed  CAS  Google Scholar 

  9. Takekawa H, Takaoka K, Tsukamoto E, et al. (1997) Thallium-201 single photon emission computed tomography as an indicator of prognosis for patients with lung carcinoma. Cancer 80:198–203

    Article  PubMed  CAS  Google Scholar 

  10. Nakahara T, Togawa T, Nagata M, et al. (2003) Comparison of barium swallow, CT and thallium-201 SPECT in evaluating responses of patients with esophageal squamous cell carcinoma to preoperative chemoradiotherapy. Ann Nucl Med 17:583–591

    Article  PubMed  Google Scholar 

  11. Sun SS, Shih CS, Hsu NY, et al. (2001) Detection of esophageal carcinoma using single photon emission computed tomography with thallium-201: a preliminary report. Anticancer Res 21:4109–4112

    PubMed  CAS  Google Scholar 

  12. Arbab AS, Koizumi K, Arai T, et al. (1996) Application of Tc-99m-tetrofosmin as a tumor imaging agent: comparison with Tl-201. Ann Nucl Med 10:271–274

    Article  PubMed  CAS  Google Scholar 

  13. Swisher SG, Erasmus J, Maish W, et al. (2004) 2-Fluoro-2-deoxy-D-glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma. Cancer 101:1776–1785

    Article  PubMed  Google Scholar 

  14. Cerfolio RJ, Bryant AS (2006) Maximum standardized uptake values on positron emission tomography of esophageal cancer predicts stage, tumor biology, and survival. Ann Thorac Surg 82:391–395

    Article  PubMed  Google Scholar 

  15. Hatano E, Ikai I, Higashi T, et al. (2006) Preoperative positron emission tomography with fluorine-18-fluorodeoxyglucose is predictive of prognosis in patients with hepatocellular carcinoma after resection. World J Surg 30:1736–1741

    Article  PubMed  Google Scholar 

  16. Vural G, Atasever T, Ozdemir A, et al. (1997) 201Tl scintigraphy in the evaluation of palpable and nonpalpable breast lesions: correlation with mammography and ultrasonography. Nuklearmedizin 36:282–288

    PubMed  CAS  Google Scholar 

  17. Martin WH, Delbeke D, Patton JA, et al. (1996) Detection of malignancies with SPECT versus PET, with 2-[fluorine-18]fluoro-2-deoxy-D-glucose. Radiology 198:225–231

    PubMed  CAS  Google Scholar 

  18. Macfarlane DJ, Cotton L, Ackermann RJ, et al. (1995) Triple-head SPECT with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG): initial evaluation in oncology and comparison with FDG PET. Radiology 194:425–429

    PubMed  CAS  Google Scholar 

  19. Inokuma T, Tamaki N, Torizuka T, et al. (1995) Value of fluorine-18-fluorodeoxyglucose and thallium-201 in the detection of pancreatic cancer. J Nucl Med 36:229–235

    PubMed  CAS  Google Scholar 

  20. Kawakami Y, Suga K, Yamashita T, et al. (2005) Initial application of respiratory-gated 201Tl SPECT in pulmonary malignant tumours. Nucl Med Commun 26:303–313

    Article  PubMed  Google Scholar 

  21. Flamen P, Lerut A, Van Cutsem E, et al. (2000) Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J Clin Oncol 18:3202–3210

    PubMed  CAS  Google Scholar 

  22. Flamen P, Lerut T, Haustermans K, et al. (2004) Position of positron emission tomography and other imaging diagnostic modalities in esophageal cancer. Q J Nucl Med Mol Imaging 48:96–108

    PubMed  CAS  Google Scholar 

  23. Pauwels EK, Ribeiro MJ, Stoot JH, et al. (1998) FDG accumulation and tumor biology. Nucl Med Biol 25:317–322

    Article  PubMed  CAS  Google Scholar 

  24. Mariette C, Taillier G, Van Seuningen I, et al. (2004) Factors affecting postoperative course and survival after en bloc resection for esophageal carcinoma. Ann Thorac Surg 78(4):1177–1183

    Article  PubMed  Google Scholar 

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Acknowledgment

This work was supported in part by Samsung grant #C-A6-419-2.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwondong, Kangnamgu, Seoul, Korea

    Hyun Woo Chung, Kyung-Han Lee, Eun Jeong Lee, Su ** Lee, Young Seok Cho, Joon Young Choi & Byung-Tae Kim

  2. Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Young Mog Shim & Kwhanmien Kim

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  1. Hyun Woo Chung
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  2. Kyung-Han Lee
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  3. Eun Jeong Lee
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  4. Su ** Lee
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  5. Young Seok Cho
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  6. Joon Young Choi
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  7. Young Mog Shim
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  8. Kwhanmien Kim
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  9. Byung-Tae Kim
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Correspondence to Kyung-Han Lee.

Additional information

Presented in part at the 51st Annual Meeting of the Society of Nuclear Medicine, Philadelphia, PA, USA, June 19–23, 2004.

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Chung, H.W., Lee, KH., Lee, E.J. et al. Comparison of Uptake Characteristics and Prognostic Value of 201Tl and 18F-FDG in Esophageal Cancer. World J Surg 32, 69–75 (2008). https://doi.org/10.1007/s00268-007-9276-z

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  • DOI: https://doi.org/10.1007/s00268-007-9276-z

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