TY - JOUR
T1 - FDG-PET in esophageal cancer
T2 - Incremental value over computed tomography
AU - Yeung, Henry W.D.
AU - Macapinlac, Homer A.
AU - Mazumdar, Madhu
AU - Bains, Manjit
AU - Finn, Ronald D.
AU - Larson, Steven M.
N1 - Funding Information:
This work is partially supported by the Laurent and Alberta Gerschel Foundation.
PY - 1999
Y1 - 1999
N2 - Objectives: To evaluate the clinical utility of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with cancer (CA) of the esophagus, and its incremental value over computed tomography (CT) scan. Methods: Positron emission tomography (PET) scan and CT scan reports of all patients with biopsyproven CA esophagus from December 1995 to August 1998 were reviewed. PET images were acquired on a high-resolution dedicated PET scanner 45 minutes to 1 hour after intravenous injection of 370 MBq of fluorine-18-fluorodeoxyglucose (F-18-FDG). Emission images of the neck, chest, and abdomen were obtained, followed by transmission scans at selected sites. Results: One hundred fifty-one scans were performed on 109 patients. The clinical indications were staging (67), follow-up evaluation after chemoradiation (66), and evaluation of possible recurrence after surgery (18). A final diagnosis was reached in 99 patients at 276 sites by histology (91.3%) or clinical follow-up of over 6 months (8.7%). FDG-PET scan showed a sensitivity of 80%, specificity of 95%, and accuracy of 86% compared with 68%, 81%, and 73% for CT. Of the 32 false negatives, 23 were perigastric or paraesophageal lymph nodes close to the primary, and 5 were peritoneal or pleural spread. PET detected 99% of the primary lesion (66 out of 67) with a mean standardized uptake value (SUV) of 11 (3.6 to 46). There was no apparent difference in 18F-fluorodeoxyglucose (FDG) uptake between squamous cell CA (N = 15, mean SUV 10.5), adenoCA (N = 48, mean SUV 11.2), and other cell types (N = 3, mean SUV 10.3). The one case where PET missed the primary lesion turned out to have a lesion measuring 0.4 cm in its maximum diameter. In 20 patients out of the 99 with confirmed diagnosis (20%), PET detected 24 confirmed lesions not seen on CT, and in 14 patients (14%) management was changed as a result of the PET finding. Conclusion: FDG-PET scan is more accurate than CT (86% vs. 73%; P = 0.0002) in the evaluation of patients with CA esophagus. It provides additional information over CT, impacting on management in 14% of patients.
AB - Objectives: To evaluate the clinical utility of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with cancer (CA) of the esophagus, and its incremental value over computed tomography (CT) scan. Methods: Positron emission tomography (PET) scan and CT scan reports of all patients with biopsyproven CA esophagus from December 1995 to August 1998 were reviewed. PET images were acquired on a high-resolution dedicated PET scanner 45 minutes to 1 hour after intravenous injection of 370 MBq of fluorine-18-fluorodeoxyglucose (F-18-FDG). Emission images of the neck, chest, and abdomen were obtained, followed by transmission scans at selected sites. Results: One hundred fifty-one scans were performed on 109 patients. The clinical indications were staging (67), follow-up evaluation after chemoradiation (66), and evaluation of possible recurrence after surgery (18). A final diagnosis was reached in 99 patients at 276 sites by histology (91.3%) or clinical follow-up of over 6 months (8.7%). FDG-PET scan showed a sensitivity of 80%, specificity of 95%, and accuracy of 86% compared with 68%, 81%, and 73% for CT. Of the 32 false negatives, 23 were perigastric or paraesophageal lymph nodes close to the primary, and 5 were peritoneal or pleural spread. PET detected 99% of the primary lesion (66 out of 67) with a mean standardized uptake value (SUV) of 11 (3.6 to 46). There was no apparent difference in 18F-fluorodeoxyglucose (FDG) uptake between squamous cell CA (N = 15, mean SUV 10.5), adenoCA (N = 48, mean SUV 11.2), and other cell types (N = 3, mean SUV 10.3). The one case where PET missed the primary lesion turned out to have a lesion measuring 0.4 cm in its maximum diameter. In 20 patients out of the 99 with confirmed diagnosis (20%), PET detected 24 confirmed lesions not seen on CT, and in 14 patients (14%) management was changed as a result of the PET finding. Conclusion: FDG-PET scan is more accurate than CT (86% vs. 73%; P = 0.0002) in the evaluation of patients with CA esophagus. It provides additional information over CT, impacting on management in 14% of patients.
KW - Esophageal Cancer
KW - F-18 FDG
KW - Positron Emission Tomography
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U2 - 10.1016/S1095-0397(99)00035-7
DO - 10.1016/S1095-0397(99)00035-7
M3 - Article
C2 - 14516649
AN - SCOPUS:0001049922
SN - 1095-0397
VL - 2
SP - 255
EP - 260
JO - Clinical Positron Imaging (Netherlands)
JF - Clinical Positron Imaging (Netherlands)
IS - 5
ER -