Positron emission tomography in esophageal cancer

Abstract

Positron emission tomography (PET), a functional imaging modality, has provided the transition between the research environment and the clinical environment over the last 10 years. Its primary use is in the field of oncology, where it is being increasingly used in the management of several tumor types including esophageal cancer. 18 F-Fluorodeoxyglucose PET (FDG-PET) scans may also be used to distinguish between benign and malignant tumors, to identify different stages of tumor spread, to assess for tumor recurrence, and monitor the response to therapy of malignant diseases. This review aims to outline the current and future roles of PET scanning in the field of esophageal cancer.

The clinical application of 18F‐fluorodeoxyglucose positron emission tomography to predict survival in patients with operable esophageal cancer

“…9 With regard to staging accuracy, the incremental diagnostic information provided by FDG-PET led to a change of staging in 14% of the patients with esophageal cancer, compared with conventional imaging. 19,20 Similar results have been reported by other groups. 5,6,8,19,21,22 In general, a change in International Union Against Cancer (UICC) stage occurs in approximately 20% of the patients with esophageal cancer using FDG-PET compared with conventional imaging modalities.…”

“…A whole-body image was initiated 40 minutes after the injection of FDG using the simultaneous emission/transmission method. 20 Between 4 and 5 sections were imaged from head to thigh for a period of 8 minutes per section. Patients had fasted for at least 4 hours before FDG-PET.…”

“…Patients had fasted for at least 4 hours before FDG-PET. Our institutional review board approved the imaging protocols, 20 and all patients provided informed consent before undergoing the examination. Two experienced nuclear medicine physicians qualitatively evaluated all PET images.…”

The Efficacy of FDG-PET for the Management of Esophageal Cancer: Review Article

“…26,27) It is difficult to judge the depth of invasion of esophageal cancer using FDG-PET. 10,28,29) Kato et al reported the detection rate of primary tumor for each depth of invasion (T1-T4). 10) According to that report, the primary tumor was visualized by FDG-PET in 119 of 149 patients (80%).…”

The Role of PET-CT in the Clinical Management of Oesophageal Cancer

“…The current staging modalities utilize an array of morphological imaging studies, and more recently, minimally invasive surgical techniques, to bridge the gap between clinical and pathological staging. The introduction of PET-CT has provided an incremental yield to the diagnostic accuracy in oesophageal cancer staging (10)(11). PET-CT provides an increased sensitivity and specificity of metastatic disease compared to other morphological imaging techniques (PET-CT vs CT: sensitivity 71% vs 52% and specificity 93% vs 91%), changing the operability in up to 20% of patients (12)(13).…”