Impact of 18F-FDG PET/CT on therapeutic management in the initial staging of esophageal cancer

The number of pathologic lymph nodes involved is still a significant prognostic factor even after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma

“…The recent TNM system includes the number of involved LNs, which is in line with our findings and those of many others. However, despite the recent advances in diagnostic tools, such as PET‐CT and MRI systems 29, 30, even in the cases without adjuvant therapy, it is often difficult to determine the correct number of positive LNs by only clinical evaluation, and this fact may cause a large discrepancy between the clinical and pathologic LN status. Since the importance of the metastatic LNs has been demonstrated, it is now necessary to develop another useful modality to precisely detect involved LNs as early as possible in order to more accurately predict a patient's prognosis, and provide more aggressive treatments for those considered to have a poorer prognosis.…”

The Role of Maximum Standardized Uptake Value in PET/CT as a Prognostic Factor in Patients with Resected Esophageal Squamous Cell Carcinoma

“…Since Yasuda and colleagues first applied PET to esophageal tumor detection in 1995, recent studies have reported on its diverse roles in the preoperative staging, prognostic evaluation, identification of the response to neoadjuvant chemotherapy, and detection of recurrence in esophageal cancer. [8][9][10][11][12][13] Our study focused more on the results of preoperative PET/ CT than on postoperative pathology because it can predict overall survival (OS) and DFS, which might allow individualized therapy strategies in patients with ESCC. The mSUV was selected as parameter because it is considered to be the most important parameter in all cancer and mSUV is less variable than mean SUV.…”

“…8,9 PET/CT offers a quantitative value of the tumor aggressiveness by maximum standardized uptake value (mSUV) which is outstanding for detecting lymph node and distant metastasis. [10][11][12] Despite the widespread use of PET/CT in esophageal cancer and existing research related to its role for determining prognosis, the actual meaning of mSUV is still uncertain in predicting the prognosis of ESCC.…”

18F-FDG PET/CT Has a High Impact on Patient Management and Provides Powerful Prognostic Stratification in the Primary Staging of Esophageal Cancer: A Prospective Study with Mature Survival Data

“…Over the past decade, PET/CT has become established in cancer imaging, allowing the functional information of PET to be fused with the anatomic information from CT. Several studies have reported PET/CT to be more accurate than either PET alone or CSI in assessing locoregional lymph nodes and in detecting distant metastatic disease (15)(16)(17)(18)(19)(20)(21)(22)(23). Given the importance of disease stage to treatment choice, this superior accuracy is likely to have a high impact on management decisions.…”