Use of Positron Emission Tomography in Surgery Follow-Up of Esophageal Cancer

Abstract

FDG-PET appears to be very useful for the systematic follow-up of asymptomatic patients after esophagectomy with an initial scan performed 6 months after surgery.

Diagnostic Performance of 18F-FDG PET and PET/CT for the Detection of Recurrent Esophageal Cancer After Treatment with Curative Intent: A Systematic Review and Meta-Analysis

“…The general characteristics of the included studies are presented in Table 2 (17)(18)(19)(20)(21)(22)(23)(24). Table 3 outlines the used 18 F-FDG PET or PET/CT parameters and reference standards.…”

“…Table 3 outlines the used 18 F-FDG PET or PET/CT parameters and reference standards. Only 1 of the 8 studies was prospectively designed to answer this research question (22). The duration of clinical follow-up after acquisition of a 18 F-FDG PET or PET/CT scan was less than 6 mo in 1 of the included studies (23), at least 6 mo or longer in 5 studies (17,18,20,21,24), and not described in 2 other studies (19,22).…”

“…Only 1 of the 8 studies was prospectively designed to answer this research question (22). The duration of clinical follow-up after acquisition of a 18 F-FDG PET or PET/CT scan was less than 6 mo in 1 of the included studies (23), at least 6 mo or longer in 5 studies (17,18,20,21,24), and not described in 2 other studies (19,22). In 4 studies, the diagnostic value of integrated 18 F-FDG PET/CT was analyzed (17,18,20,21), and 3 studies analyzed the diagnostic value of standalone 18 F-FDG PET (22)(23)(24).…”

Efficacy of PET-CT in the Diagnosis and Treatment of Recurrence After Esophageal Cancer Surgery

“…In the systematic review and meta-analysis by Goense et al, the sensitivity of PET-CT ranged between 89% and 100% and the specificity between 55% and 94% for the detection of recurrent EC (23). On the other hand, previous studies reported that the sensitivity of contrast-enhanced CT ranged between 65% and 89% and specificity between 79% and 91.2% for the detection of recurrent EC (8,24). Although the lower specificity of PET-CT is a limitation for patients with EC, its higher sensitivity may contribute to the early start of treatments for recurrent tumors, which may, in turn, improve the prognosis of patients with recurrent EC.…”

“…It is impossible to evaluate viable tumor tissues using the other imaging modalities, CT and magnetic resonance imaging, whereas PET-CT has the ability to evaluate cancer function on the basis of information on glucose metabolism. Comparisons between cancer metabolism revealed by PET-CT before and after treatments enables evaluation of responses to treatments (6,24,25). Previous studies reported that decreases of standardized uptake value in tumors evaluated by PET-CT after preoperative chemoradiotherapy were associated with histopathological tumor responses (26,27).…”