Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma

Kato, Hiroyuki; Kuwano, Hiroyuki; Nakajima, Masahiro; Miyazaki, Tatsuya; Yoshikawa, Minako; Ojima, Hitoshi; Tsukada, Katsuhiko; Oriuchi, Noboru; INOUE, TOMIO; Endo, Keigo

doi:10.1002/cncr.10330.abs

Cited by 75 publications

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“…All patients underwent curative thoracic esophagectomy that included the esophagogastric junction. 20 After surgery, the lymph nodes were separated from the resected esophagus and the adjacent tissue and assigned specific numbers indicating the localization of the lymph node, in accordance with the guidelines of the Japanese Society for Esophageal Diseases (JSED). 25 Surgical specimens were fixed, embedded, stained with hematoxylin and eosin, and microscopically examined by two pathologists.…”

Section: Treatment and Clinical Outcomementioning

confidence: 99%

“…16 -19 In a previous study, we reported that compared with computed tomography (CT), FDG-PET was more useful in the staging of esophageal squamous cell carcinoma (SCC) and offered higher sensitivity, specificity, and accuracy rates with regard to lymph node detection, particularly in the neck and the upper thoracic region. 20 Preoperative FDG-PET imaging has led to the incidental detection of unsuspected distant metastases in Ͼ 20% of patients with esophageal carcinoma. 6,7,21,22 Accurate preoperative staging, particularly with regard to the depth of tumor invasion, lymph node involvement, and distant metastases, is vital in determining the most appropriate procedures for curative surgery for thoracic esophageal carcinoma.…”

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confidence: 99%

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The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinoma

Kato

Miyazaki

Nakajima

et al. 2004

Cancer

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223

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BACKGROUNDThe purpose of the current study was to assess whether [18F]fluorodeoxyglucose positron emission tomography (FDG‐PET) provides incremental value (e.g., additional information on lymph node involvement or the presence of distant metastases) compared with computed tomography (CT) in patients with esophageal carcinoma.METHODSThe authors examined 149 consecutive patients with thoracic esophageal carcinoma. Eighty‐one patients underwent radical esophagectomy without pretreatment, 17 received chemoradiotherapy followed by surgery, 3 underwent endoscopic mucosal resection, and the remaining 48 patients received definitive radiotherapy and chemotherapy. The diagnostic accuracy of FDG‐PET and CT was evaluated at the time of diagnosis.RESULTSThe primary tumor was visualized using FDG‐PET in 119 (80%) of 149 patients. Regarding lymph node metastases, FDG‐PET had 32% sensitivity, 99% specificity, and 93% accuracy for individual lymph node group evaluation and 55% sensitivity, 90% specificity, and 72% accuracy for lymph node staging evaluation. PET exhibited incremental value over CT with regard to lymph node status in 14 of 98 patients who received surgery: 6 patients with negative CT findings were eventually shown to have lymph node metastases (i.e., they had positive PET findings and a positive reference standard [RS]); 6 patients with positive CT findings were shown not to have lymph node metastases (i.e., they had negative PET findings and a negative RS); and 2 patients were shown to have cervical lymph node metastases in addition to mediastinal or abdominal lymph node metastases. Among the remaining patients, PET showed incremental value over CT with regard to distant organ metastases in six patients. The overall incremental value of PET compared with CT with regard to staging accuracy was 14% (20 of 149 patients).CONCLUSIONSFDG‐PET provided incremental value over CT in the initial staging of esophageal carcinoma. At present, combined PET‐CT may be the most effective method available for the preoperative staging of esophageal tumors. Cancer 2005. © 2004 American Cancer Society.

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Section: Treatment and Clinical Outcomementioning

confidence: 99%

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confidence: 99%

The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinoma

Kato

Miyazaki

Nakajima

et al. 2004

Cancer

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223

106

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“…Comparison of FDG uptake in the primary tumor and clinicopathologic staging findings showed that there is a significant association between the FDG uptake in the primary tumor and depth of invasion 16. In our study, when applying SUVmax 3.05 as cutoff point in discriminating ≤T1a from higher stage cancers, sensitivity, specificity, and accuracy were 74.8% (98/131), 70.1% (213/304), and 71.5% (311/435) respectively.…”

Section: Discussionmentioning

confidence: 99%

Surgically resected T1‐ and T2‐stage esophageal squamous cell carcinoma: T and N staging performance of EUS and PET/CT

et al. 2018

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This study aimed to evaluate the frequency of nodal metastases and to disclose the diagnostic performance of endoscopic ultrasonography (EUS) and PET/CT in T and N staging in surgically resected early‐stage esophageal squamous cell carcinomas (eSCCs). Institutional review board approved this retrospective study with waiver of informed consent for reviewing medical record. We included 435 patients with an early T‐stage (Tis or T1a [≤T1a], T1b and T2) eSCC. The rates of metastatic lymphadenopathy were calculated. Then, the performance of EUS and PET/CT in subdividing T and N stages was assessed. 131 ≤ T1a, 234 T1b, and 70 T2 eSCCs were identified. In discriminating ≤T1a from other cancers, the sensitivity, specificity, and accuracy of EUS were 60.3% (79/131), 80.3% (244/304), and 74.3% (323/435) respectively. With ROC curve analysis, cut‐off value of SUVmax 3.05 at PET provided sensitivity 74.8% (98/131), specificity 70.1% (213/304), and accuracy 71.5% (311/435) for differentiating ≤T1a eSCCs from others. Ten (7.6%) of 131 ≤ T1a cancers had nodal metastasis. In discriminating N0 from node‐positive disease, sensitivity, specificity, and accuracy of EUS were 89.6% (267/298), 41.6% (57/137), and 74.5% (324/435), respectively, whereas those of PET/CT were 88.9% (265/298), 38.7% (53/137), and 73.1% (318/435) respectively. In >70% of patients with ≤T1a eSCCs, the tumor stage can be discriminated from higher stage cancers by using EUS or PET/CT. Substantial percentage (7.6%) of ≤T1a eSCC patients have nodal metastases, which are missed in more than half of the patients in clinical staging.

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“…However, its spatial resolution is limited. Kato et al20 reported that the minimal diameter of detectable malignant lesions of the esophagus is 5 mm. Therefore, FDG‐PET has not been considered useful for detection of minimal or superficial cancer.…”

Section: Discussionmentioning

confidence: 99%

¹⁸F‐Fluorodeoxyglucose positron emission tomography can be used to determine the indication for endoscopic resection of superficial esophageal cancer

et al. 2018

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18F‐Fluorodeoxyglucose positron emission tomography (FDG‐PET) is a useful imaging modality that reflects the tumor activity. However, FDG‐PET is mainly used for advanced cancer, not superficial cancer. In this study, we investigated the relationship between the superficial tumor depth of esophageal cancer and the FDG uptake to determine the indications for endoscopic resection (ER). From 2009 to 2017, 444 patients with esophageal cancer underwent esophagectomy or endoscopic submucosal dissection (ESD), and 195 patients were pathologically diagnosed with superficial cancer. Among them, 146 patients were examined by FDG‐PET before esophagectomy or ESD. In these 146 patients, the relationship between the pathological tumor depth and FDG uptake was analyzed. The mean maximum standardized uptake value in pT1a‐EP/LPM tumors was 1.362 ± 0.890, that in pT1a‐MM/pT1b‐SM1 tumors was 2.453 ± 1.872, and that in pT1b‐SM2/SM3 tumors was 4.265 ± 3.233 (P < .0001). Among 51 pT1a‐EP/LPM tumors, 10 (19.6%) showed positive detection of FDG. For pT1a‐MM/pT1b‐SM1 and pT1b‐SM2/SM3 tumors, the detection rate was 52.9% (18/34) and 82.0% (50/61), respectively. The detection rate of pT1a‐EP/LPM was significantly lower than in the other two groups (P < .0001). Among 10 FDG‐PET‐positive lesions, only 1 had no apparent reason for PET positivity; however, 9 of 10 had a suitable reason for detectability by PET and inadequacy for ER. Negative detection of superficial esophageal squamous cell carcinoma by FDG‐PET is useful to determine the indication for ER when the tumor depth cannot be diagnosed even after performing magnifying endoscopy with narrow band imaging and endoscopic ultrasonography. When FDG uptake is recognized, a therapeutic modality other than ER should be considered.

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Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma

Cited by 75 publications

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The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinoma

The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinoma

Surgically resected T1‐ and T2‐stage esophageal squamous cell carcinoma: T and N staging performance of EUS and PET/CT

¹⁸F‐Fluorodeoxyglucose positron emission tomography can be used to determine the indication for endoscopic resection of superficial esophageal cancer

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Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma

Cited by 75 publications

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The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinoma

The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinoma

Surgically resected T1‐ and T2‐stage esophageal squamous cell carcinoma: T and N staging performance of EUS and PET/CT

18F‐Fluorodeoxyglucose positron emission tomography can be used to determine the indication for endoscopic resection of superficial esophageal cancer

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¹⁸F‐Fluorodeoxyglucose positron emission tomography can be used to determine the indication for endoscopic resection of superficial esophageal cancer