Does the association of 18F-FDG uptake intensity and lesion topography reveal histological phenotype and tumor differentiation in esophageal cancer?

F-FDG PET/CT of 87 patients with ESCC and EAD was performed to investigate the role played by both histopathological subtype and tumor differentiation in the characterization of glucose metabolic profile of EC. Esophageal squamous cell cancer was well differentiated (WD) in 42 cases and poorly differentiated (PD) in 12 patients. Twenty-one of the 33 patients had WD EAD, while 12 had a PD EAD. The 18 F-FDG maximal standardized uptake value (SUV max ) was determined for all lesions and used for inter and intra-group comparison. In ESCC, the SUV max ranged from 4 to 31 with a mean value of 16±6. In EAD, the SUV max ranged from 2 to 25 with a mean value of 10±6. A statistically significant difference (P<0.0001) was found between ESCC and EAD. According to histological classification and tumor differentiation, we obtained the following results: a) the SUV max values of WD ESCC and WD EAD were 17±5 (range:7-31) and 7±3 (range:2-12) respectively (P<0.00001), b) the SUV max values of PD ESCC and PD EAD were 11±4 (range:4-19) and 17±6 (range:725) respectively (P<0.05). Moreover, a statistically significant difference of SUV max values was found between WD and PD ESCC (P<0.005) as well as between WD and PD differentiated EAD (P<0.0001). In order to predict tumor histology (ESCC, EAD) from both SUV max and lesion location, a multivariate discriminant analysis was performed on the whole population with a resulting diagnostic accuracy equal to 82% (P<0.00001). In conclusion, we provide additional arguments about 18