Title: Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma
Authors: Flamen, Patrick ×
Lerut, Antoon
Van Cutsem, Eric
De Wever, Walter
Peeters, M
Stroobants, Sigrid
Dupont, Patrick
Bormans, Guy
Hiele, Martin
De Leyn, Paul
Van Raemdonck, Dirk
Coosemans, Willy
Ectors, Nadine
Haustermans, Karin
Mortelmans, Luc #
Issue Date: Sep-2000
Series Title: Journal of Clinical Oncology vol:18 issue:18 pages:3202-3210
Abstract: PURPOSE: A prospective study of preoperative tumor-node-metastasis staging of patients with esophageal cancer (EC) was designed to compare the accuracy of 18-F-fluoro-deoxy-D-glucose (FDG) positron emission tomography (PET) with conventional noninvasive modalities. PATIENTS AND METHODS: Seventy-four patients with carcinomas of the esophagus (n = 43) or gastroesophageal junction (n = 31) were studied. All patients underwent attenuation-corrected FDG-PET imaging, a spiral computed tomography (CT) scan, and an endoscopic ultrasound (EUS). RESULTS: FDG-PET demonstrated increased activity in the primary tumor in 70 of 74 patients (sensitivity: 95%). False-negative PET images were found in four patients with T1 lesions. Thirty-four patients (46%) had stage IV disease. FDG-PET had a higher accuracy for diagnosing stage IV disease compared with the combination of CT and EUS (82% v 64%, respectively; P: =.004). FDG-PET had additional diagnostic value in 16 (22%) of 74 patients by upstaging 11 (15%) and downstaging five (7%) patients. Thirty-nine (53%) of the 74 patients underwent a 2- or 3-field lymphadenectomy in conjunction with primary curative esophagectomy. In these patients, tumoral involvement was found in 21 local and 35 regional or distant lymph nodes (LN). For local LN, the sensitivity of FDG-PET was lower than EUS (33% v 81%, respectively; P: =.027), but the specificity may have been higher (89% v 67%, respectively; P: = not significant [NS]). For the assessment of regional and distant LN involvement, compared with the combined use of CT and EUS, FDG-PET had a higher specificity (90% v 98%, respectively; P: =. 025) and a similar sensitivity (46% v 43%, respectively; P: = NS). CONCLUSION: PET significantly improves the detection of stage IV disease in EC compared with the conventional staging modalities. PET improves diagnostic specificity for LN staging.
ISSN: 0732-183X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Thoracic Surgery
Translational Research in GastroIntestinal Disorders
Translational Cell & Tissue Research
Nuclear Medicine & Molecular Imaging
Laboratory of Experimental Radiotherapy
Research Group Experimental Neurology
Laboratory for Cognitive Neurology
Clinical Digestive Oncology (+)
× corresponding author
# (joint) last author

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