Korean J Thorac Cardiovasc Surg.  1999 Apr;32(4):388-393.

Staging of Esophageal Cancer Using Positron Emission Tomography: Comparing to Computed Tomography

• Shim YM
• Park SJ
• Kim BT
• Kim SC

Abstract

BACKGROUND: Correct preoperative staging of esophageal cancer is a prerequisite for adequate treatment. We prospectively compared the accuracy of positron emission tomography (PET) with [fluorine-18]FDG in the staging of esophageal cancer to that of computed tomography (CT). MATERIAL AND METHOD: The findings of FDG PET and of chest CT including lower neck and the upper abdomen of 20 biopsy-proven squamous cell carcinoma patients (male, 19; female, 1; mean age, 61) were compared with the pathologic findings obtained from a curative esophagectomy with lymph node dissection. RESULT: The sensitivities of FDG PET and CT for diagnosis of primary tumor were the same, 90.0% (18/20). Both FDG PET and CT failed to show the primary tumor in 2 of 20 patients; one had a 1cm sized carcinoma in situ and the other had T1 stage cancer. By using the results of the pathologic examinations of 193 removed lymph node groups, we calculated the diagnostic sensitivities, specificities and accuracies of PET and CT (*x2 p < 0.005). Sensitivity** Specificity Accuracy* PET 55.6%(30/54) 97.1%(135/139) 85.5%(165/193) CT 13.0%(7/54) 98.6%(137/139) 74.6%(144/193) One of four patients with a false-positive for PEThad had active pulmonary tuberculosis. Among the 24 tumor involved lymph node groups, PET failed to show tumor metastasis in 5 lymph node groups abutting the tumor and in 14 lymph node groups located where the decay correction was not performed.
CONCLUSION
Based on the above findings, it is suggested that [F-18]FDG-PET is superior to CT in the detection of nodal metastases and in the staging of patients with esophageal cancer.

Keyword

Tomography, emission computed; Tomography, X-ray computed; Esophageal neoplasm

MeSH Terms

Abdomen
Carcinoma in Situ
Carcinoma, Squamous Cell
Diagnosis
Electrons*
Esophageal Neoplasms*
Esophagectomy
Female
Humans
Lymph Node Excision
Lymph Nodes
Neck
Neoplasm Metastasis
Positron-Emission Tomography*
Prospective Studies
Sensitivity and Specificity
Tomography, Emission-Computed
Tomography, X-Ray Computed
Tuberculosis, Pulmonary