Computed tomography and positron emission tomography in the pre-operative staging of oesophageal carcinoma

Rankin, Sheila; Taylor, Harris C.; Cook, Gary; Mason, Robert C.

doi:10.1016/s0009-9260(98)80292-4

Cited by 137 publications

(66 citation statements)

References 22 publications

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“…The sensitivities of CT and FDG-PET for the detection of regional lymph node metastases were lower. It is already known that lymph nodes adjacent to the primary oesophageal cancer are difficult to discriminate from the primary tumour with FDG-PET (McAteer et al, 1999), which is due to the intense activity in the primary cancer and the limited spatial resolution of PET (Luketich et al, 1997;Rankin et al, 1998). Low sensitivity of CT for regional lymph node can at least partly be explained by the fact that CT is not able to detect metastases in normal-sized lymph nodes (Choi et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Staging investigations for oesophageal cancer: a meta-analysis

et al. 2008

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The aim of the study was to compare the diagnostic performance of endoscopic ultrasonography (EUS), computed tomography (CT), and 18 F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in staging of oesophageal cancer. PubMed was searched to identify English-language articles published before January 2006 and reporting on diagnostic performance of EUS, CT, and/or FDG-PET in oesophageal cancer patients. Articles were included if absolute numbers of true-positive, false-negative, falsepositive, and true-negative test results were available or derivable for regional, celiac, and abdominal lymph node metastases and/or distant metastases. Sensitivities and specificities were pooled using a random effects model. Summary receiver operating characteristic analysis was performed to study potential effects of study and patient characteristics. Random effects pooled sensitivities of EUS, CT, and FDG-PET for regional lymph node metastases were 0. .86 -0.96) for CT, respectively. Diagnostic performance of FDG-PET for distant metastases was significantly higher than that of CT, which was not significantly affected by study and patient characteristics. The results suggest that EUS, CT, and FDG-PET each play a distinctive role in the detection of metastases in oesophageal cancer patients. For the detection of regional lymph node metastases, EUS is most sensitive, whereas CT and FDG-PET are more specific tests. For the evaluation of distant metastases, FDG-PET has probably a higher sensitivity than CT. Its combined use could however be of clinical value, with FDG-PET detecting possible metastases and CT confirming or excluding their presence and precisely determining the location(s).

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Section: Discussionmentioning

confidence: 99%

Staging investigations for oesophageal cancer: a meta-analysis

et al. 2008

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“…It has been reported that in all esophageal cancer patients, abnormal FDG accumulation is detected in primary tumors, with the average detection rate exceeding 90% (15,(20)(21)(22)(23). However, as the spatial resolution of PET or PET-CT is poor, it is limited in its ability to detect small tumors; in addition, the adjacent invasion of a primary tumor is difficult to assess in most cases (7,14).…”

Section: Discussionmentioning

confidence: 99%

Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the¹⁸F-FDG Positron Emission Tomography CT Correlation

Yoon

Jung

Park

et al. 2010

J Korean Soc Radiol

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Purpose:To investigate the size criteria of multidetector computed tomography (MD-CT) for the evaluation metastatic lymph nodes (LNs) for potentially operable squamous esophageal cancer, and to compare this information with the results of positron emission tomography-CT (PET-CT). Materials and Methods: Twenty-four patients who underwent radical esophagectomy for esophageal cancer were studied. All patients had preoperative MDCT and PET-CT. The MDCT findings were compared with those of PET-CT and were correlated with the surgical records. The receiver operating characteristic (ROC) curve method was used to determine the appropriate cut-off value to distinguish benign from metastatic LNs. Results: The size of metastatic LNs (9.35 3.41 mm) was significantly larger than that of benign LNs (5.741.64 mm) (p<0.001). The best cut-off value was 7 mm (81.8% sensitivity, 80.8% specificity). PET-CT detected all metastatic LNs except for four in the peritumoral region. The sensitivity and specificity of metastatic LN evaluation on PET-CT were 82.6% and 99.4%, respectively. Only one LN without metastasis showed increased fluoro-2-deoxy-D-glucose uptake on PET-CT. Conclusion: Size of metastatic LNs can typically be < 10 mm. For MDCT, the short diameter of 7 mm may be the optimal criterion. PET-CT is very accurate for the assessment of metastatic LNs except for those in the peritumoral region.

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“…Primary tumor detection has been reported in 69 -100% of patients with esophageal carcinoma. Some studies have reported that all patients with esophageal carcinoma had abnormal FDG accumulation in the primary tumor 8,10,13,32 ; the average detection rate in those reports was Ͼ 90%. Himeno et al 35 reported that PET imaging could detect primary esophageal tumors with an invasion status of T1b or greater (i.e., tumors involving the submucosa), whereas T1a tumors (i.e., tumors invading the muscularis mucosae) were undetectable.…”

Section: Discussionmentioning

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

223

107

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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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Computed tomography and positron emission tomography in the pre-operative staging of oesophageal carcinoma

Cited by 137 publications

References 22 publications

Staging investigations for oesophageal cancer: a meta-analysis

Staging investigations for oesophageal cancer: a meta-analysis

Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the¹⁸F-FDG Positron Emission Tomography CT Correlation

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

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Computed tomography and positron emission tomography in the pre-operative staging of oesophageal carcinoma

Cited by 137 publications

References 22 publications

Staging investigations for oesophageal cancer: a meta-analysis

Staging investigations for oesophageal cancer: a meta-analysis

Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the18F-FDG Positron Emission Tomography CT Correlation

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

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Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the¹⁸F-FDG Positron Emission Tomography CT Correlation