Skip to main content

Advertisement

SpringerLink
Log in

18F-FAMT-PET Is Useful for the Diagnosis of Lymph Node Metastasis in Operable Esophageal Squamous Cell Carcinoma

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The role and potential usefulness of positron emission tomography (PET) scanning in certain tumors has been widely investigated in recent years. 18F-FAMT (L-[3-18F]-α-methyltyrosine) is an amino acid tracer for PET. This study investigated whether PET/CT with 18F-FAMT provides additional information for preoperative diagnostic workup of esophageal squamous cell carcinoma compared with that obtained by 18F-FDG (fluorodeoxyglucose) PET or CT.

Methods

PET/CT studies with 18F-FAMT and 18F-FDG were performed as a part of the preoperative workup in 21 patients with histologically confirmed esophageal squamous cell carcinoma.

Results

For the detection of primary esophageal cancer, 18F-FAMT-PET exhibited a sensitivity of 76.2%, whereas the sensitivity for 18F-FDG-PET was 90.5% (P = 0.214). 18F-FAMT uptake in primary tumors showed significant correlation with depth of invasion (P = 0.005), lymph node metastasis (P = 0.045), stage (P = 0.031), and lymphatic invasion (P = 0.029). In the evaluation of individual lymph node groups, 18F-FAMT-PET exhibited 18.2% sensitivity, 100% specificity, 71.9% accuracy, 100% positive predictive value, and 70.0% negative predictive value, compared with 24.2%, 93.7%, 69.8%, 66.6%, and 70.2%, respectively, for 18F FDG-PET. CT exhibited 39.4% sensitivity, 85.7% specificity, 69.8% accuracy, 59.1% positive predictive value, and 73.0% negative predictive value. The specificity of 18F-FAMT-PET is significantly higher than that of 18F-FDG-PET (P = 0.042) and CT (P = 0.002). 18F-FAMT-PET did not have any false-positive findings compared to those with 18F-FDG-PET.

Conclusions

Our findings suggest that the addition of 18F-FAMT-PET to 18F-FDG-PET and CT would permit more precise staging of esophageal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Daly JM, Karnell LH, Menck HR. National Cancer Data Base report on esophageal carcinoma. Cancer. 1996;78:1820–8.

    Article  CAS  PubMed  Google Scholar 

  2. Wobst A, Audisio RA, Colleoni M, Geraghty JG. Oesophageal cancer treatment: studies, strategies and facts. Ann Oncol. 1998;9:951–62.

    Article  CAS  PubMed  Google Scholar 

  3. Kato H, Kuwano H, Nakajima M, et al. Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma. Cancer. 2002;94:921–8.

    Article  PubMed  Google Scholar 

  4. Brock CS, Meikle SR, Price P. Does fluorine-18 fluorodeoxyglucose metabolic imaging of tumours benefit oncology? Eur J Nucl Med. 1997;24:691–705.

    CAS  PubMed  Google Scholar 

  5. Kato H, Takita J, Miyazaki T, et al. Correlation of 18-F-fluorodeoxyglucose (FDG) accumulation with glucose transporter (Glut-1) expression in esophageal squamous cell carcinoma. Anticancer Res. 2003;23:3263–72.

    CAS  PubMed  Google Scholar 

  6. Kato H, Nakajima M, Sohda M, et al. The clinical application of 18F-fluorodeoxyglucose positron emission tomography to predict survival in patients with operable esophageal cancer. Cancer. 2009;115:3196–203.

    Article  PubMed  Google Scholar 

  7. Tomiyoshi K, Amed K, Muhammad S, et al. Synthesis of isomers of 18F-labelled amino acid radiopharmaceutical: position 2- and 3-L-18F-alpha-methyltyrosine using a separation and purification system. Nucl Med Commun. 1997;18:169–75.

    Article  CAS  PubMed  Google Scholar 

  8. Inoue T, Tomiyoshi K, Higuichi T, et al. Biodistribution studies on L-3-[fluorine-18]fluoro-alpha-methyl tyrosine: a potential tumor-detecting agent. J Nucl Med. 1998;39:663–7.

    CAS  PubMed  Google Scholar 

  9. Amano S, Inoue T, Tomiyoshi K, Ando T, Endo K. In vivo comparison of PET and SPECT radiopharmaceuticals in detecting breast cancer. J Nucl Med. 1998;39:1424–7.

    CAS  PubMed  Google Scholar 

  10. Uchino H, Kanai Y, Kim DK, et al. Transport of amino acid-related compounds mediated by L-type amino acid transporter 1 (LAT1): insights into the mechanisms of substrate recognition. Mol Pharmacol. 2002;61:729–37.

    Article  CAS  PubMed  Google Scholar 

  11. Kim DK, Kanai Y, Choi HW, et al. Characterization of the system L amino acid transporter in T24 human bladder carcinoma cells. Biochim Biophys Acta. 2002;1565:112–21.

    Article  CAS  PubMed  Google Scholar 

  12. Kaira K, Oriuchi N, Otani Y, et al. Diagnostic usefulness of fluorine-18-alpha-methyltyrosine positron emission tomography in combination with 18F-fluorodeoxyglucose in sarcoidosis patients. Chest. 2007;131:1019–27.

    Article  PubMed  Google Scholar 

  13. Kaira K, Oriuchi N, Otani Y, et al. Fluorine-18-alpha-methyltyrosine positron emission tomography for diagnosis and staging of lung cancer: a clinicopathologic study. Clin Cancer Res. 2007;13:6369–78.

    Article  CAS  PubMed  Google Scholar 

  14. Kaira K, Oriuchi N, Shimizu K, et al. Evaluation of thoracic tumors with 18F-FMT and 18F-FDG PET-CT: a clinicopathological study. Int J Cancer. 2009;124:1152–60.

    Article  CAS  PubMed  Google Scholar 

  15. Japanese Society for Esophageal Disease. Guidelines for the clinical and pathological studies on carcinoma of the esophagus. 10th ed. Tokyo: Kanehara; 2008.

    Google Scholar 

  16. Hamacher K, Coenen HH, Stöcklin G. Efficient stereospecific synthesis of no-carrier-added 2-[18F]-fluoro-2-deoxy-d.-glucose using aminopolyether supported nucleophilic substitution. J Nucl Med. 1986;27:235–8.

    CAS  PubMed  Google Scholar 

  17. Beck JR. Likelihood ratios. Another enhancement of sensitivity and specificity. Arch Pathol Lab Med. 1986;110:685–6.

    CAS  PubMed  Google Scholar 

  18. Kuwano H, Sumiyoshi K, Sonoda K, et al. Relationship between preoperative assessment of organ function and postoperative morbidity in patients with oesophageal cancer. Eur J Surg. 1998;164:581–6.

    Article  CAS  PubMed  Google Scholar 

  19. Bar-Shalom R, Valdivia AY, Blaufox MD. PET imaging in oncology. Semin Nucl Med. 2000;30:150–85.

    Article  CAS  PubMed  Google Scholar 

  20. Meltzer CC, Luketich JD, Friedman D, et al. Whole-body FDG positron emission tomographic imaging for staging esophageal cancer comparison with computed tomography. Clin Nucl Med. 2000;25:882–7.

    Article  CAS  PubMed  Google Scholar 

  21. Flamen P, Lerut A, Van Cutsem E, et al. Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J Clin Oncol. 2000;18:3202–10.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgment

We thank Dr. Keisuke Ieta, Dr. Yasuyuki Fukai, Dr. Ryokuhei Manda, Dr. Hitoshi Ojima, and Dr. Katsuhiko Tsukada for valuable cooperation, and Ms. Tomoko Yano, Ms. Hideko Emura, Ms. Midori Ohno, Ms. Miwako Ida, and Ms. Yukie Saito for their excellent secretarial assistance.

Author information

Authors and Affiliations

  1. Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

    Makoto Sohda, Shigemasa Suzuki, Naritaka Tanaka, Akihiko Sano, Makoto Sakai, Takanori Inose, Masanobu Nakajima, Tatsuya Miyazaki, Minoru Fukuchi & Hiroyuki Kuwano

  2. Department of Surgical Oncology, Dokkyo Medical University, Mibu, Japan

    Hiroyuki Kato

  3. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan

    Noboru Oriuchi & Keigo Endo

Authors
  1. Makoto Sohda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroyuki Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shigemasa Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naritaka Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Akihiko Sano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Makoto Sakai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takanori Inose
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masanobu Nakajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tatsuya Miyazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Minoru Fukuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Noboru Oriuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Keigo Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Hiroyuki Kuwano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Makoto Sohda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sohda, M., Kato, H., Suzuki, S. et al. 18F-FAMT-PET Is Useful for the Diagnosis of Lymph Node Metastasis in Operable Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 17, 3181–3186 (2010). https://doi.org/10.1245/s10434-010-1177-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-010-1177-y

Keywords

Search

Navigation