Staging of esophageal cancer with 18F-fluorodeoxyglucose positron emission tomography.

Flanagan, Fidelma; Dehdashti, Farrokh; Siegel, Barry A.; Trask, D D; Sundaresan, Sudhir; Patterson, G. A.; Cooper, Joel D.

doi:10.2214/ajr.168.2.9016218

Cited by 278 publications

(112 citation statements)

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“…In a retrospective study , Flanagan et al (1991) compared FDG-PET and CT for staging tumours of the oesophagus and found an accuracy of the detection of nodal involvement of 45% for CT, which is somewhat lower than reported in the literature, and 76% for PET, which is lower than in the current study. The higher spatial resolution of the PET scanner used in the present study (6 mm vs 10 mm) may account for this difference (Flanagan, 1997).…”

Section: Discussionmentioning

confidence: 81%

Positron emission tomography for staging of oesophageal and gastroesophageal malignancy

Kole

Plukker²,

Nieweg³

et al. 1998

Br J Cancer

166

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Summary Positron emission tomography (PET) with [18F]-fluoro-2-deoXy-D-glucose (FDG) was prospectively investigated as a means of detecting metastatic disease in patients with oesophageal tumours and compared with computerized tomography (CT), with the surgical findings as a gold standard. Twenty-six patients with a malignant tumour of the oesophagus or gastroesophageal junction underwent CT and PET of the chest and the abdomen. Seven patients underwent laparoscopy to establish resectability. Fifteen patients underwent laparotomy without prior laparoscopy. Four patients did not undergo surgery. The primary tumour was visualized in 81% of patients with CT and in 96% with PET. Neither CT nor PET were suited to assess the extent of wall invasion. Surgically assessed nodal status corresponded in 62% with CT and in 90% with PET. Distant metastases were found in five patients with CT and in eight with PET. The diagnostic accuracy of CT in determining resectability was 65% and for PET 88%. For CT and PET together this was 92%. The present study indicates that FDG-PET can be of importance for staging patients with oesophageal tumours. PET has a higher sensitivity for nodal and distant metastases and a higher accuracy for determining respectability than CT. PET and CT together would have decreased ill-advised surgery by 90%.

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Section: Discussionmentioning

confidence: 81%

Positron emission tomography for staging of oesophageal and gastroesophageal malignancy

Kole

Plukker²,

Nieweg³

et al. 1998

Br J Cancer

166

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“…20,21 Several authors have reported that FDG-PET shows greater sensitivity than CT in the diagnosis of involved regional lymph nodes and have suggested that PET may have a role as a staging modality in esophageal carcinoma. [12][13][14] One study showed that PET had a sensitivity, specificity, and accuracy for lymph nodes metastases of 92% (12/13), 88% (7/8), and 90% (19/21), respectively, compared with 38% (5/13), 100% (8/8), and 59% (13/22), respectively, for CT scanning. 14 Our findings on lymph node staging were very similar.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11] Markedly increased FDG uptake in esophageal squamous cell carcinoma (SCC) has been documented in several studies, [12][13][14][15] and they have reported that PET using FDG shows greater sensitivity in the diagnosis of involved regional lymph nodes than computed tomography (CT). This suggests that PET may have a role in evaluating the stage of esophageal carcinoma.…”

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confidence: 99%

“…[12][13][14] Most of these studies assessed the degree of accuracy with which PET detected metastasis in lymph nodes as a measure of lymph node staging. [12][13][14] Although it is important to ascertain in each patient if an esophageal carcinoma has spread to the lymph nodes at the time of surgery, it is more important to know the extent of regional spread. It is not yet certain how accurately FDG-PET can determine the spread of cancer to individual lymph nodes.…”

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confidence: 99%

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

Kato

Kuwano

Nakajima

et al. 2002

Cancer

275

100

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“…2,3,9,11 Moreover, esophageal carcinoma patients who are responding to chemoradiation by PET have a significant correlation with pathologic response and survival. 9,[12][13][14] PET has been shown to be accurate and sensitive in detecting recurrent esophageal carcinoma as well. 2,3 Despite these findings, the value of baseline PET in patients with localized esophageal and gastroesophageal junction carcinoma in prognosticating outcome has not been established.…”

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confidence: 99%

Value of baseline positron emission tomography for predicting overall survival in patient with nonmetastatic esophageal or gastroesophageal junction carcinoma

Hong

Lunagómez

Kim

et al. 2005

Cancer

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BACKGROUNDThe value of baseline positron emission tomography (PET) for predicting overall survival (OS) or disease‐free survival (DFS) is unclear in patients with nondistant metastatic (locoregional only) esophageal carcinoma. The authors tested the hypothesis that, in this setting, the number of PET abnormalities (NPA) would correlate with OS and DFS.METHODSThe authors of the current study analyzed patients with localized esophageal carcinoma (Stages II and III) who had a baseline PET and endoscopic ultrasonography (EUS) and were all treated with chemoradiotherapy followed by surgery. The standardized uptake value (SUV) of PET avid lesions were evaluated for: SUV of the primary, NPA, peak SUV, and total SUV. Correlations were performed with baseline EUS results, OS, DFS, and clinical and pathologic response.RESULTSForty‐seven patients who underwent chemoradiotherapy followed by surgery were analyzed. Most patients had clinical Stage III cancer. NPA was significantly associated with OS (Cox model, P = 0.02; log‐rank test, P = 0.04) and DFS (P = 0.04). Patients with NPA > 1 had a death hazard ratio of 4.49 (reference, NPA = 1). In a multivariate analysis, NPA was independently predictive of OS (P = 0.03). Alternatively, SUV of the primary tumor, peak SUV, total SUV, and EUS clinical stage did not correlate with the type of response, OS or DFS.CONCLUSIONSData from the current study suggest that for nondistant metastatic esophageal carcinoma, baseline PET can predict patient outcome. Baseline NPA (> 1), reflecting the regional nodal metastases, is an independent predictor of OS. Baseline PET may become a useful stratification factor in randomized trials and for individualizing therapy. Cancer 2005. © 2005 American Cancer Society.

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Staging of esophageal cancer with 18F-fluorodeoxyglucose positron emission tomography.

Cited by 278 publications

References 0 publications

Positron emission tomography for staging of oesophageal and gastroesophageal malignancy

Positron emission tomography for staging of oesophageal and gastroesophageal malignancy

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

Value of baseline positron emission tomography for predicting overall survival in patient with nonmetastatic esophageal or gastroesophageal junction carcinoma

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