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Visual PET/CT Scoring for Nonspecific 18F-FDG Uptake in the Differentiation of Early Malignant and Benign Esophageal Lesions

Johannes B. Roedl1,2, Rivka R. Colen1,2, Kevin King1, Alan J. Fischman2, Peter R. Mueller1 and Michael A. Blake1

1 Division of Abdominal and Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St., Boston, MA 02114.
2 Division of Nuclear Medicine, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.


Figure 1
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  		Fig. 1A —71-year-old man with diagnosis of T1 adenocarcinoma (arrows): focal and eccentric pattern (focality–eccentricity score, 3). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 2
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  		Fig. 1B —71-year-old man with diagnosis of T1 adenocarcinoma (arrows): focal and eccentric pattern (focality–eccentricity score, 3). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 3
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  		Fig. 1C —71-year-old man with diagnosis of T1 adenocarcinoma (arrows): focal and eccentric pattern (focality–eccentricity score, 3). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 4
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  		Fig. 2A —62-year-old man with diagnosis of Barrett's esophagus (arrows): segmental and eccentric pattern (focality–eccentricity score, 2). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 5
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  		Fig. 2B —62-year-old man with diagnosis of Barrett's esophagus (arrows): segmental and eccentric pattern (focality–eccentricity score, 2). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 6
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  		Fig. 2C —62-year-old man with diagnosis of Barrett's esophagus (arrows): segmental and eccentric pattern (focality–eccentricity score, 2). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 7
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  		Fig. 3A —64-year-old man with diagnosis of radiation esophagitis (arrows): segmental and concentric pattern (focality–eccentricity score: 1). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 8
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  		Fig. 3B —64-year-old man with diagnosis of radiation esophagitis (arrows): segmental and concentric pattern (focality–eccentricity score: 1). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 9
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  		Fig. 3C —64-year-old man with diagnosis of radiation esophagitis (arrows): segmental and concentric pattern (focality–eccentricity score: 1). "Hot iron" color map (A), axial (B), and sagittal (C) PET/CT images show 20-step color map.

 

Figure 10
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  		Fig. 4A —59-year-old woman with diagnosis of reflux esophagitis (arrows): diffuse and concentric pattern (focality–eccentricity score: 0). Axial PET/CT image shows "hot-iron" color map.

 

Figure 11
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  		Fig. 4B —59-year-old woman with diagnosis of reflux esophagitis (arrows): diffuse and concentric pattern (focality–eccentricity score: 0). Diffuse uptake is best seen on PET alone (gray-scale) as shown on axial (B) and sagittal (C) images.

 

Figure 12
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  		Fig. 4C —59-year-old woman with diagnosis of reflux esophagitis (arrows): diffuse and concentric pattern (focality–eccentricity score: 0). Diffuse uptake is best seen on PET alone (gray-scale) as shown on axial (B) and sagittal (C) images.

 

Figure 13
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  		Fig. 5 —Receiver operator characteristic (ROC) curves of focality–eccentricity score (solid line), intensity score (long dashes), and absolute standardized uptake value (short dashes) in differentiating benign from early malignant esophageal lesions. Detailed results are given in Table 3.

 

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