F-18-FDG and C-11-choline positron emission tomography in human esophago-gastric cancer: prediction of response to therapy

Stuart Suttie, Dympna McAteer, Margaret Sheehan, Marianne Nicolson, Lutz Schweiger, Solveig Hammonds, Timothy Smith, Andrew Welch, Kenneth Park

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Background: To determine the utility of F-18-FDG and C-11-Choline uptake, in patients with esophageal and esophago-gastric junction tumors who are to undergo either neo-adjuvant or palliative chemotherapy, in predicting response (pathological and survival).

Methods: Eighteen patients with biopsy proven cancer were recruited prospectively. Patients underwent PET imaging before and during the first cycle of chemotherapy (seven and 14 days) with both F-18-FDG and C-11-Choline. Tracer uptake was quantified using Standardized Uptake Values. Pathological tumor response was determined using the Mandard criteria. Cellular proliferation was determined using ki-67 immunohistochemistry. Relationships between tracer uptake and response, one-year survival and cellular proliferation were determined.

Results: All 18 tumors were imaged by F-18-FDG PET compared to 16/18 with C-11-Choline. Change in uptake of either tracer did not correlate with pathological response. Pathological response did not influence survival (median-survival, responders = 16.1 months; non-responders = 19.0 months, p = 0.978). There was no significant correlation of change in tracer uptake with survival. C-11-Choline tumor uptake did not correlate with cellular proliferation.

Conclusion: F-18-FDG PET is superior for imaging of the primary tumor. Neither F-18-FDG nor C-11-Choline PET was able to predict response accurately.
Original languageEnglish
Pages (from-to)66-77
Number of pages12
JournalWorld Journal of Oncology
Issue number2
Publication statusPublished - Apr 2010


  • positron emission tomography
  • esophageal cancer
  • F-18-FDG
  • C-11-choline
  • response


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