Total-Body PET/CT Metabolic Response in Esophageal Squamous Cell Carcinoma.
Authors
Affiliations (10)
Affiliations (10)
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Shanghai Institute of Medical Imaging, Shanghai, 200032, China; Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China; Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
- Department of Radiology, University of California, Davis, Sacramento, CA, 95817, USA.
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Queen Rania Street Al Jubeiha, Amman, 11941, Jordan.
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
- Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
- Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia; Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
- Department of Nuclear Medicine and Theranostics, St. Luke's Medical Center, Quezon City, Philippines.
- Department of Nuclear Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350001, China; Fujian Research Institute of Nuclear Medicine, Fuzhou 350001, China.
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Shanghai Institute of Medical Imaging, Shanghai, 200032, China; Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China; Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. Electronic address: [email protected].
Abstract
Esophageal squamous cell carcinoma (ESCC) exhibits heterogeneous responses to neoadjuvant therapy, necessitating early and accurate assessment. [<sup>18</sup>F]fluorodeoxyglucose ([<sup>18</sup>F]FDG) PET/CT enables quantitative assessment of tumor glucose metabolism, correlating with pathological remission and long-term outcomes, while [<sup>18</sup>F] or [<sup>68</sup>Ga]Ga-labeled fibroblast activation protein inhibitor (FAPI) PET/CT evaluates stromal metabolism, providing complementary information. Total-body PET/CT (uEXPLORER, United Imaging Healthcare Co.Ltd., Shanghai, China) with 194-cm long-axial field-of-view (LAFOV) offers long axial coverage, up to 68-fold higher sensitivity than conventional systems. It enables low-dose, rapid imaging, dynamic whole-body parametric imaging, and improves detection of small, low-uptake lesions as well as metastatic lesions in the distal upper or lower extremities in a single bed position. Delayed and dual-time imaging protocols, alone and/or combined with deep learning-based synthetic CT, further improve lesion detectability while minimizing radiation exposure. This narrative review summarizes evidence from conventional PET/CT studies, highlights the technical and clinical advantages of total-body PET/CT, and discusses its feasibility, quantitative capabilities, and potential to guide response-adapted management in ESCC based on our institutional experience.