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

Abstract

Abstract. Aim The present study aimed to retrospectively investigate the utility of positron-emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography (PET-CT) in regular followEsophageal cancer (EC) is the eighth most common cancer worldwide, with an estimated 456,000 new cases in 2012 (3.2% of all cases), and the sixth most common cause of death from cancer, with an estimated 400,000 deaths (4.9% of all deaths)(1). Although several diagnostic modalities and multimodal therapies have been developed in recent years, the prognosis of patients with EC remains poor even when curative surgery is performed. Postoperative recurrence occurs in 78% of patients who undergo curative surgery for EC (2, 3). Recurrence of EC is regarded as a grave prognostic sign after curative surgery, with most patients dying due to the progression of their cancer. However, a few patients with postoperative recurrence have achieved long-term survival (4, 5). The development of more effective therapies or examinations is presumed to have improved the clinical outcomes of patients with recurrent EC. In order to achieve further improvements in the prognosis of these patients, the characteristics of recurrent cases that survive long-term, and prognostic factors for recurrent EC need to be elucidated in more detail.Positron-emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose, an analog of glucose, integrated with computed tomography (PET-CT) is a functional imaging technique based on increased glucose uptake and glycolysis by cancer cells. In Japan, EC was approved as an indication for the use of PET-CT under health insurance coverage in April 2006. PET-CT is now widely used and provides a sensitive and specific examination for the staging or diagnosis of recurrent lesions in various lips of cancer (6-8). Furthermore, a previous study showed that PET-CT was useful for the early detection of recurrence after esophagostomy, and contributed to a good prognosis through early detection of single recurrent tumors (5). Although the utility of PET-CT in EC has been reported, an appropriate method for applying PET-CT to follow-up after curative surgery for EC has not yet been established. In order to provide EC patients the best medical care, it is necessary to clarify the utility of PET-CT in postoperative follow-up.PET-CT was implemented at our Institution in March 2007. We have been conducting imaging observations for regular follow-up of patients who underwent curative surgery for EC in our Division using PET-CT since January 2008. The present study aimed to retrospectively investigate the 5473

Study on incidence of oesophageal carcinoma in patients undergoing upper gastrointestinal endoscopy for upper gastrointestinal symptoms in a secondary care hospital

“…8 Positron emission tomographycomputed tomography (PET-CT) is superior over PET or CT alone and have a reported accuracy of nearly 60% and 90% in the ability to detect loco regional lymph-node and distant metastasis respectively. 9 For the oesophagus, severe hyperplasia/carcinoma in situ, mucosal carcinoma and submucosal carcinoma were categorised as the early stage cancer and invasive carcinoma was categorised as the late stage cancer. 10 Treatment options vary according to patient presenting stage, patient performance status and local expertise.…”

Role of precision imaging in esophageal cancer

“…Routine imaging with CT and PET/CT has been effective in the systematic follow-up of asymptomatic patients and early detection of recurrence (81-84) (Figure 9). However, there has been no established protocol for a follow-up yet (84).…”

“…Therefore, integrated PET/CT seems to be the most accurate modality for the detection of recurrent esophageal cancer (35). PET/CT has the advantage of scanning the whole body and the ability to detect small lymph node metastases up to 0.9 mm diameter as well as recurrent tumors outside the body (84,85).…”