^18FDG—PET在肺癌诊断中的价值

目的研究氟脱氯葡萄糖F18-正电子发射计算机电子扫描(18FDG-PET)在鉴别肺部肿块性质和肺癌术前纵隔淋巴结转移分期中的应用价值.方法对34例肺部肿块患者进行18FDG-PET和CT检查,PET资料分别采用目测法和计算标准化摄取值(SUV)的半定量法进行分析,并同病理结果对照.结果目测法18FDG-PET诊断肺部肿块性质的敏感度、准确度分别是93%、85%;CT分别为63%、53%,2种方法差异有显著性意义(P＜0.05);半定量法准确度为74%,与CT相比,差异也有显著性意义(P＜0.05).肺部恶性肿块的SUV是4.4±1.9,良性为2.2±1.7,2者差异有显著性意义(P＜0.05).18FDG-PET和CT2种检查方法术前对纵隔淋巴结转移的分期与病理结果符合率分别为100%和78%,2者差异有显著性意义(P＜0.05).结论同CT相比,18FDG-PET能更准确地鉴别肺部肿块性质及确定纵隔淋巴结转移分期,是一种较好的无创性肺癌诊断技术.     

18F-FDG符合线路SPECT显像诊断胃癌

目的 探讨^18F-FDG符合线路SPECT显像在胃癌诊断中的应用价值。方法对18例经组织病理学证实的胃癌患者的^18F-FDG符合线路SPECT显像进行分析，并与近期CT结果比较。结果①符合线路SPECT检出原发性胃癌的敏感性、特异性和阳性预测值分别为88．9％、100％和88．9％。②18例手术患者中，胃局部淋巴结转移12例，符合线路SPECT显像检出7例，其敏感性、特异性和阳性预测值分别为58．3％、100％和58．3％。③符合线路显像检出远处转移6例，CT仅检出2例。④对6例同时行^18F-FDG符合线路SPECT显像与锝[^99Tc^m]-亚甲基二膦酸盐(^99Tc^m-MDP)骨显像的患者进行分析，发现两者所示骨病灶部位不尽一致。结论^18F-FDG符合线路SPECT显像诊断胃癌较为灵敏，检出胃癌局部淋巴结及远处转移可能优于CT。     

贲门癌淋巴结转移相关影像学因素的CT诊断研究

目的探讨CT检出淋巴结数目、大小与淋巴结转移的关系。方法对65例根治性手术切除的贲门癌螺旋CT检出淋巴结情况进行回顾性分析。利用PACS工作站进行图像阅读,将CT检出淋巴结数目及大小情况按照有无转移进行统计学比较,利用ROC曲线,分析应用CT检出淋巴结数目及大小指标诊断贲门癌淋巴结转移的敏感性和特异性。结果(1)转移组CT检出淋巴结数目平均为(14.20±7.72)枚,明显多于非转移组(6.86±3.37)枚。(2)No.1、3、7组淋巴结转移组与非转移组CT检出数目差异具有统计学意义。(3)ROC曲线分析,检出淋巴结总数8枚作为判断转移的最佳截割点,敏感性82.4%,特异性71.4%;No.1、3、7组共检出5枚淋巴结作为判断转移的最佳截割点,敏感性82.4%,特异性71.4%;CT检出最大淋巴结直径为12mm作为判断转移的最佳截割点,敏感性80.4%,特异性78.6%。(4)联合检出8枚淋巴结和最大淋巴结直径为12mm标准进行串联试验,敏感性72.5%,特异性92.9%。结论(1)淋巴结的总检出数与淋巴结转移有一定的相关性;(2)No.1、3、7组为贲门癌转移好发组,当三组检出总数>5枚时提示转移可能;(3)结合CT检出淋巴结数目、大小等相关影像学指标进行综合分析,有助于提高贲门癌淋巴结转移CT诊断的特异性。     

18FDG PET/CT在术前检测食管癌淋巴结转移及分期中的应用

目的观察^18FDG PET/CT在术前检测食管癌淋巴结转移及分期的临床应用价值.方法随机选择拟行手术治疗的食管癌病人30例,术前1周内行^18FDG PET/CT检查,12例病人同期行CT增强扫描,术前均不接受放化疗,根据术后病理对比PET/CT与CT诊断食管癌淋巴结转移及确定淋巴结分期的价值.结果22例存在淋巴结转移,共切取并分离淋巴结243枚,转移淋巴结49枚.PET/CT诊断淋巴结转移的敏感性、特异性、准确性分别为93.9%、91.2%、91.8%,CT分别为40.8%、96.9%、85.6%;PET/CT阳性与阴性预测值分别为73.0%,98.3%,CT为76.9%,86.6%.PET/CT确定淋巴结分期的敏感性、特异性、准确性分别为95.5%、62.5%、86.7%,CT分别为72.7%、75.0%、73.3%.结论18FDG PET/CT图像融合技术诊断食管癌淋巴结转移及确定淋巴结分期临床应用价值优于CT.     

CT检查用于肺癌纵隔淋巴结转移的临床意义的探讨

本文通过对46例原发性肺癌病人手术探查纵隔淋巴结的结果与术前CT检查纵隔淋巴结的结果进行对照分析,结果表明:(1)以纵隔淋巴结直径超过10mm为转移阳性;CT检查的敏感性为53.3％,特异性为93.5％,预期准确性80％;(2)纵隔转移的发生率以隆突下组为最高,淋巴结大小和转移病变的发生率密切。     

pN2/Ⅲ期非小细胞肺癌五年生存期与纵隔淋巴结转移相关性的回顾性分析

目的 探讨N2淋巴结转移状态对pN2/Ⅲ期非小细胞肺癌(NSCLC)预后的影响.方法 接受手术治疗的pN2/Ⅲ期NSCLC患者206例,分析N2淋巴结转移状态并计算其纵隔淋巴结转移率(MLNR),通过Kaplan-Meier法和Cox比例风险模型分析纵隔淋巴结转移状态与NSCLC患者术后总生存时间(OS)的关系.结果 206例pN2/Ⅲ期NSCLC患者中位生存时间29.6个月;Kaplan-Meier分析显示,多站N2淋巴结转移、N2淋巴结转移数＞2枚、N2跳跃性转移、隆突下淋巴结转移阳性以及高纵隔淋巴结转移率(MLNR,≥33％)的患者生存时间明显缩短(P＜0.05).Cox比例风险模型分析显示,隆突下淋巴结转移阳性(HR=1.81,95％ CI 1.18,2.79,P＜0.01),MLNR≥33％ (HR=1.54,95％ CI 1.02,2.33,P＜0.05)是影响NSCLC患者预后的独立危险因素.结论 纵隔淋巴结跳跃性转移、隆突下淋巴结转移、纵隔淋巴结转移站数和转移数目以及MLNR与pN2/Ⅲ期NSCLC患者术后OS显著相关,可能是影响pN2/Ⅲ期NSCLC患者预后的危险因素.     

甲状腺乳头状癌前上纵隔淋巴结转移与临床病理因素相关性分析

目的：为探讨临床病理学因素与前上纵隔淋巴结转移的相关性,从而进一步探讨甲状腺癌颈淋巴结清扫手术中同期前上纵隔淋巴结清扫的临床意义。 方法：纳入54例甲状腺乳头状癌患者,在做颈淋巴结清扫的过程中,同时行前上纵隔淋巴结清扫取样进行临床研究,比较其与性别、年龄、肿瘤的大小、多灶性、有无甲状腺外侵犯、有无淋巴血管侵犯,第6区淋巴结转移情况等临床病理因素的相关性。 结果：甲状腺乳头状癌患者的甲状腺肿瘤直径>4 cm、肿瘤有血管淋巴侵犯、6区淋巴结转移>3个,与前上纵隔淋巴结转移有关（P<0.05）,而与性别、年龄、多灶性、有无甲状腺外侵犯无关（P>0.05）。 结论：临床病理学因素与前上纵隔淋巴结转移具有关,甲状腺癌颈淋巴结清扫手术中同期前上纵隔淋巴结清扫对治疗甲状腺乳头状癌具有一定的临床意义。     

胸部电子计算机断层扫描对肺癌外科治疗的临床意义

目的；探讨胸部电子计算机断层扫描（CT）检查对肺癌外科治疗的临床意义。方法：选择380例经手术治疗的肺癌患者，将胸部X线片和胸部CT检查结果与手术和病理检查结果作对照分析。结果：胸部CT对病变定位准确性优于胸部X线片，但定性诊断仍有一定限制。对纵隔淋巴结转移的诊断准确性为84％，特异性为59％，敏感性为97％，阳性预测率为82％，阴性预测率为90％。结论：胸部CT检查对纵隔淋巴结转移的评估优于胸部X线片，但对病灶定性仍有一定的局限性。     

PET/CT诊断乳腺癌及腋窝淋巴结状态的作用评价

目的：评价PET／CT诊断乳腺癌和腋窝淋巴结转移的临床价值。方法：对33例疑似乳腺癌病人进行PET／CT检查，定性分析肿瘤病灶、淋巴结摄取氟脱氧葡萄糖（FDG）的程度，半定量测量标准摄取值（SUV），根据乳腺和淋巴结的FDG摄取强度诊断乳腺癌和淋巴结转移，检验SUV与乳腺癌分化程度、有丝分裂计数的关联性。结果：PET／CT诊断乳腺癌和腋窝淋巴结转移的敏感度、特异度和精确度分别为92．6％、100％、93．9％和82．3％、90％、85．2％；SUV与乳腺癌分化程度、有丝分裂计数显著相关（P〈0．05）；诊断乳腺癌的Kappa指数=0．835，μ=8．48，（P〈0．01）。结论：PET／CT诊断乳腺癌和腋窝淋巴结转移的敏感度、特异度较高，作为一种非侵袭性检查方法，可提供乳腺癌在活体内的多方面生物学信息，为选择合理的手术方式及新辅助化疗提供参考，弥补传统检查方法的不足。     

18F-FDG符合线路显像判断纵隔淋巴结转移

回顾性分析18F-FDG符合线路显像在非小细胞肺癌(NSCLC)手术前N分期中的作用,并与CT的N分期进行比较,旨在探讨符合线路显像在判断NSCLC纵隔淋巴结转移中的价值.     

Prediction of true-negative lymph node metastasis in clinical IA non-small cell lung cancer by measuring standardized uptake values on positron emission tomography

Purpose

We developed a method for predicting true-negative lymph node metastases in clinical IA non-small lung cancer (NSCLC) by the combined evaluation of computed tomography (CT), 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) findings and the maximum standardized uptake value (SUVmax) of primary tumors.

Methods

The subjects of this study were 94 patients with clinical stage IA NSCLC who underwent both preoperative CT and FDG-PET. We analyzed the relationship between the SUVmax of primary tumors and various clinicopathological factors to find the best method available for assessing true-negative lymph node metastasis.

Results

The pathological stages were IA (n = 80), IB (n = 4), IIA (n = 5), IIIA (n = 4), and IV (n = 1). Pathologic lymph node metastasis was recognized in nine patients and the SUVmax of these tumors ranged from 3.3 to 20.3. A SUVmax of 3.0 was defined as the cut-off point and patients were dichotomized according to this point. Tumors with SUVmax of 3.0 or less were associated with a significantly lower incidence of pleural and vascular invasion and were characterized by the degree of differentiation.

Conclusion

The SUVmax of primary tumors reflects the grade of malignancy; therefore, the combined evaluation of FDG-PET/CT findings with the SUVmax of primary tumors may help predict lymph node metastasis negativity.     

肝细胞癌18F-FDG PET/CT最大标准化摄取值的影响因素

目的 探讨肝细胞癌的18F-FDG PET/CT最大标准化摄取值（SUVmax）与临床病理特征的关系。方法 回顾性分析上海交通大学附属新华医院2011年7月至2015年1月间35例行肝细胞癌手术切除患者的18F-FDG PET/CT影像学资料,对可能影响原发肿瘤SUVmax的因素,包括性别、年龄、肿瘤直径、病理分级、微血管癌栓、TMN分期、T分期、N分期进行单因素分析和多元回归分析,对原发肿瘤SUVmax预测淋巴结转移的诊断效能采用受试者工作特征（ROC）曲线进行分析。结果 单因素分析显示SUVmax与肿瘤直径、病理分级、TMN分期、N分期明显相关（P < 0.05）,与性别、年龄、微血管癌栓、T分期无明显相关（P > 0.05）。多元线性回归分析显示,病理分级、肿瘤直径、N分期是SUVmax的独立影响因素（P < 0．05）。当原发肿瘤SUVmax界值为8.78时诊断效率最高,敏感度为75％,特异度为87％。结论 肝癌SUVmax与肿瘤分化程度、肿瘤大小、淋巴结转移显著相关,肝癌SUVmax对于淋巴结转移有预测价值。     

Evaluation of 18F-2-deoxy-2-fluoro-<Emphasis Type="SmallCaps">d</Emphasis>-glucose Positron Emission Tomography for Gastric Cancer

Positron emission tomography (PET) with ¹⁸F-2-deoxy-2-fluoro-d-glucose (FDG) has been investigated as a means of detecting certain primary tumors and their metastatic disease in recent years. The aim of this study was to compare the performance of FDG-PET and operative assessment with formal pathologic staging. Altogether, 85 patients had undergone surgical treatment for gastric cancer with curative intent, with FDG-PET preoperatively. The results using FDG-PET were compared with those using computed tomography (CT); they were also correlated with the pathologic findings. For quantitative analysis, the regional tumor uptake was measured by the standard uptake value (SUV) using a region of interest technique. Using FDG-PET, the primary tumor was visualized in 75.2% of patients. A comparison of the FDG uptake and the clinicopathologic findings showed that there was a significant association between FDG uptake and the depth of invasion, the size of the tumor, and lymph node metastasis. FDG-PET scans had less accuracy for diagnosing locoregional lymph nodes than CT because of a significant lack of sensitivity (23.3% vs. 65.0%). The survival rate for patients with high FDG uptake (SUV > 4) was significantly lower than that for those with low FDG uptake (SUV < 4) (p < 0.05). FDG-PET was successful in detecting the primary gastric cancer lesion but not for finding early-stage gastric cancers. Detection of nodal metastasis also was not possible by FDG-PET. However, FDG-PET appears to provide important additional information concerning the aggressiveness of the tumor and the prognosis in patients with gastric cancer.     

Clinical utility of positron emission tomography in the diagnosis and management of periampullary neoplasms

Background This study examined the effect that 18-fluorodeoxyglucose positron emission tomography (¹⁸FDG-PET) imaging had on the clinical management of patients with suspected periampullary malignancy. Methods Fifty-four patients with suspected pancreatic neoplasms underwent both whole-body¹⁸FDG-PET and abdominal computed tomography (CT). Malignant or benign disease was confirmed pathologically in 47 patients. Results Of the 41 patients with malignancy,¹⁸FDG-PET failed to identify the primary tumor in 5 patients.¹⁸FDG-PET demonstrated increased uptake suggesting primary malignancy in 37 patients. Malignant pathology was confirmed in 36 cases.¹⁸FDG-PET identified malignant locoregional lymph node metastases in six of ten patients. All nodes identified before surgery by¹⁸FDG-PET were also seen on preoperative CT. Six patients who were thought to have resectable disease by CT were found to have distant metastasis at laparotomy.¹⁸FDG-PET did not detect metastasis in any of these cases. Before surgery,¹⁸FDG-PET identified distant metastases that were not detected by CT in one patient. Conclusions Despite high sensitivity and specificity in diagnosing periampullary malignancy,¹⁸FDG-PET did not change clinical management in the vast majority of patients previously evaluated by CT. In addition,¹⁸FDG-PET missed>10% of periampullary malignancies and did not provide the anatomical detail necessary to define unresectability.     

FDG-PET imaging for lymph node staging and pathologic tumor response after neoadjuvant treatment of non-small cell lung cancer.

PURPOSE: A number of studies have demonstrated that 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is effective for staging of lung cancer. However, the efficacy of FDG-PET for staging lung cancer after neoadjuvant treatment is still controversial. This study compared FDG-PET and computed tomography (CT) for lung cancer staging, and evaluated the ability of the two methods to predict the pathologic response of the primary tumor to neoadjuvant treatment. PATIENTS AND METHODS: Twenty-two patients who underwent neoadjuvant treatment followed by surgery were investigated. Eighteen patients received chemoradiotherapy and four patients received chemotherapy only. One hundred and three lymph node stations in the 22 patients were evaluated by FDG-PET and CT. The pathologic responses of the tumors were compared by FDG-uptake and tumor size on CT for the 15 patients who underwent FDG-PET and CT both before and after neoadjuvant treatment. RESULTS: There was no significant difference in the ability of FDG-PET or CT to predict residual viable tumor. Although positive predictive value by FDG-PET (0.29) was lower than that by CT (0.64) (p=0.04) in the mediastinal lymph nodes, there were no statistically significant differences in the other results of lymph nodes by FDG-PET and CT. Both decrease in FDG-uptake and decrease in tumor size by CT after neoadjuvant treatment correlated significantly with pathologic response in the 15 patients (p=0.003 and 0.009, respectively). CONCLUSION: FDG-PET did not appear to offer any advantages over CT for lymph node staging or for predicting the pathologic response after neoadjuvant treatment of non-small cell lung cancer.     

The sensitivity of F-fluorodeoxyglucose positron emission tomography in the evaluation of metastatic pulmonary nodules

Objective: Pulmonary metastasectomy is beneficial in select patients. The sensitivity of ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) for pulmonary metastasis is unknown. The aims of the study were to determine the accuracy of FDG-PET in detecting pulmonary metastasis and identify factors affecting sensitivity. Methods: All patients undergoing metastasectomy from September 2002 through December 2006 who had both chest computed tomography (CT) and FDG-PET scans or a fused CT/FDG-PET within 6 weeks prior to surgery were reviewed. Univariate and multivariate analysis were performed to determine predictors of positivity. Results: There were 83 patients (41 men, 42 women) who had 104 resections. Median age was 61 years (range, 32–87). In total 154 nodules were resected; 1 nodule in 47 patients and multiple in 36. Histopathology was adenocarcinoma in 94 nodules, sarcoma in 18, squamous cell carcinoma in 15, renal cell carcinoma in 7 and other in 20. At least one nodule was FDG-PET positive in 68 patients (81.9%). True positive FDG-PET was found in 104 nodules (67.5%) while 50 were false negative (32.5%). Multivariate analysis revealed tumor diameter and grade correlated with increased sensitivity of FDG-PET. Conclusion: FDG-PET is positive in only 67.5% of metastatic pulmonary nodules. Nodule size and grade affect the sensitivity of FDG-PET for metastatic pulmonary nodules. FDG-PET is not a sensitive test in the evaluation of patients considered for pulmonary metastasectomy. Moreover, a negative FDG-PET should not be used to rule out metastatic disease.     

增强CT和PET/CT对胰腺癌诊断及分期中的价值

目的 探讨增强CT和PET/CT对胰腺癌诊断及分期中的价值.方法 回顾性分析安徽医科大学第一附属医院普外科2009年10月至2013年10月间收治47例手术治疗的胰腺占位患者资料.术前均行CA19-9检查、腹部增强CT扫描及全身PET/CT扫描,比较增强CT与PET/CT在胰腺癌诊断及分期中价值.结果 47例患者中,确诊胰腺癌41例,非胰腺癌6例.CA19-9、增强CT和PET/CT对胰腺癌诊断的灵敏度分别为78.0％、80.4％和95.1％,PET/CT灵敏度优于CA19-9和增强CT,差异有统计学意义（P值分别为0.023和0.043）;在胰周淋巴结转移判断方面,PET/CT和增强CT的灵敏度分别为75.0％和41.6％,二者差异有统计学意义（P=0.019）;在肝转移判断方面,PET/CT和增强CT诊断的灵敏度分别为80.0％和60.0％,二者差异无统计学意义（P=1.0）.结论 PET/CT对胰腺癌诊断有较高灵敏度,显著优于增强CT.当肿瘤SUV值升高,PET/CT诊断仍应注意结合CA19-9、增强CT甚至MRI综合判断;PET/CT有助于发现淋巴结和远处器官转移病灶,获得更加准确的术前分期,从而避免诊断性剖腹探查手术.     

MRI and FDG-PET for Assessment of Response to Neoadjuvant Chemotherapy in Locally Advanced Rectal Cancer

Background

The purpose of this study was to assess the value of magnetic resonance imaging (MRI) and additional ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for tumor response to neoadjuvant chemotherapy (NAC) in patients with locally advanced rectal cancer (LARC).

Methods

Data on 40 patients with LARC, who were treated with NAC and underwent MRI and FDG-PET/CT before and after NAC, were analyzed retrospectively. Surgery was performed at a median of 6 weeks after NAC and the images were compared with the histological findings. The tumor regression grade 3/4 was classified as a responder.

Results

Sixteen patients were pathological responders. Receiver operating characteristic (ROC) analysis revealed that MRI total volume after NAC (MRI-TV2) and ΔMRI-TV had the highest performance to assess responders (area under the ROC curve [AUC] 0.849 and AUC 0.853, respectively). The reduction rate of the maximum standardized uptake value (ΔSUVmax) was also an informative factor (AUC 0.719). There seems no added value of adding FDG-PET/CT to MRI-TV2 and ΔMRI-TV in assessment of NAC responders judging from changes in AUC (AUC of ΔSUVmax and MRI-TV2 was 0.844, and AUC of ΔSUVmax and ΔMRI-TV was 0.846).

Conclusions

MRI-TV2 and ΔMRI-TV were the most accurate factors to assess pathological response to NAC. Although ΔSUVmax by itself was also informative, the addition of FDG-PET/CT to MRI did not improve performance. Patients with LARC who were treated by induction chemotherapy should receive an MRI examination before and after NAC to assess treatment response. A more than 70 % volume reduction shown by MRI volumetry may justify the omission of subsequent radiotherapy.     

PET/CT显像中SUVmax对骨转移瘤与骨髓瘤鉴别诊断的价值

目的 回顾性分析未知原发灶的多发性骨破坏患者PET/CT显像中骨髓瘤与骨转移瘤病变SUVmax的特征,为临床鉴别诊断提供依据.方法 CT或MRI发现的多发骨破坏患者119例,其中71例PET/CT检查后行病理检查,男40例,女31例;年龄37～87岁,平均61-3岁.病理确诊骨髓瘤21例,骨转移瘤41例.测量骨髓瘤和骨转移瘤每个骨病变的SUVmax并进行比较,采用ROC曲线获得鉴别诊断的分界点.采用单因素方差分析比较不同形态学特征(溶骨性和成骨性)骨转移瘤与骨髓瘤SUVmax的差异.结果 PET/CT在骨髓瘤病例中共检出315个病灶,在骨转移瘤病例中共检出684个病灶.骨髓瘤病灶SUVmax(3.42±1.96)值明显低于转移瘤病灶(7.03±4.15).SUVmax值为4.45时,鉴别骨髓瘤和骨转移瘤的敏感性和特异性分别为80.4%和72.4%.溶骨性骨转移瘤病灶SUVmax值(8.02±4.85)明显高于成骨性骨转移瘤(4.79±2.61)和骨髓瘤(3.37±1.92),而成骨性骨转移瘤与骨髓瘤病灶的SUVmax值差异无统计学意义(P>0.05).结论 PET/CT对未知原发灶的多发性骨破坏患者骨髓瘤与骨转移瘤的鉴别诊断具有潜在的价值,多发性骨破坏病灶SUVmax值较低和溶骨性破坏可提示骨髓瘤.     

Clinical Significance of 18F-fluorodeoxyglucose Positron Emission Tomography in Superficial Esophageal Squamous Cell Carcinoma

Purpose

To assess the clinical usefulness and significance of ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) in superficial esophageal squamous cell carcinoma (ESCC).

Methods

We examined FDG-PET for 80 consecutive patients with superficial ESCC without neoadjuvant treatment. Fifty-seven patients underwent radical esophagectomy, and 23 patients received endoscopic resection. The FDG uptake index was evaluated with clinicopathological findings, and glucose transporter 1 (Glut-1) expression in primary tumors was examined immunohistochemically.

Results

The FDG uptake in primary tumors correlated with histology, depth of tumor invasion, lymph node metastasis, lymphatic invasion, vascular invasion, and Glut-1 expression. All patients with more than 4.4 maximum standardized uptake value (SUV_max) had deeper invasion of submucosa. Among 16 patients with lymph node metastasis, only two were found to have lymph node metastasis. FDG uptake, depth of tumor invasion, lymph node metastasis, and histology were found to be prognostic factors, and histology was an independent prognostic factor. In FDG uptake–positive patients, depth of tumor invasion and histology were prognostic factors.

Conclusions

FDG-PET is useful for diagnosing tumors with deeper invasion of submucosa and is helpful in making decisions regarding endoscopic treatment for superficial ESCC. Patients with FDG uptake–positive disease, deeper invasion of submucosa, poorly differentiated tumor, and poor prognosis should receive multimodal treatment.