Comparison of 18F-FLT PET and 18F-FDG PET in esophageal cancer

Henderik L van Westreenen, David C P Cobben, Pieter L Jager, Hendrik M van Dullemen, Jelle Wesseling, Philip H Elsinga, John Th Plukker

Research output: Contribution to journalArticlepeer-review


UNLABELLED: 18F-FDG PET has gained acceptance for staging of esophageal cancer. However, FDG is not tumor specific and false-positive results may occur by accumulation of FDG in benign tissue. The tracer 18F-fluoro-3'-deoxy-3'-L-fluorothymidine (18F-FLT) might not have these drawbacks. The aim of this study was to investigate the feasibility of 18F-FLT PET for the detection and staging of esophageal cancer and to compare 18F-FLT PET with 18F-FDG PET. Furthermore, the correlation between 18F-FLT and 18F-FDG uptake and proliferation of the tumor was investigated.

METHODS: Ten patients with biopsy-proven cancer of the esophagus or gastroesophageal junction were staged with CT, endoscopic ultrasonography, and ultrasound of the neck. In addition, all patients underwent a whole-body 18F-FLT PET and 18F-FDG PET. Standardized uptake values were compared with proliferation expressed by Ki-67 positivity.

RESULTS: 18F-FDG PET was able to detect all esophageal cancers, whereas 18F-FLT PET visualized the tumor in 8 of 10 patients. Both 18F-FDG PET and 18F-FLT PET detected lymph node metastases in 2 of 8 patients. 18F-FDG PET detected 1 cervical lymph node that was missed on 18F-FLT PET, whereas 18F-FDG PET showed uptake in benign lesions in 2 patients. The uptake of 18F-FDG (median standardized uptake value [SUV(mean)], 6.0) was significantly higher than 18F-FLT (median SUV(mean), 3.4). Neither 18F-FDG maximum SUV (SUV(max)) nor 18F-FLT SUV(max) correlated with Ki-67 expression in the linear regression analysis.

CONCLUSION: In this study, uptake of 18F-FDG in esophageal cancer is significantly higher compared with 18F-FLT uptake. 18F-FLT scans show more false-negative findings and fewer false-positive findings than do 18F-FDG scans. Uptake of 18F-FDG or 18F-FLT did not correlate with proliferation.

Original languageEnglish
Pages (from-to)400-404
Number of pages5
JournalJournal of nuclear medicine : official publication, Society of Nuclear Medicine
Issue number3
Publication statusPublished - Mar 2005


  • Aged
  • Dideoxynucleosides
  • Esophageal Neoplasms
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Journal Article
  • Validation Studies


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