Translate this page into:
Clinical Utility of FDG PET/CT in Carcinoma Esophagus
Correspondence to: Brig SS Anand, Dept. of Nuclear Medicine, Army Hospital (R&R), Delhi Cantt, New Delhi 110010 Ph: 011-23338173, 23338171 Email: drssanand@gmail.com
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
Abstract
Background:
A retrospective study was performed to evaluate the utility of integrated PET/CT in localization of primary disease, detection of nodal/distant metastases, detection of residual/recurrent disease after therapy and its ability to predict long term outcome in patients with esophageal carcinoma.
Methods:
70 paients (38 males, 32 females, age group 32 to 78 years) with Carcinoma of esophagus/Gastro-esophageal junction (41 with squamous cell carcinoma and 29 with adenocarcinoma) were included in the study. 23 cases (Category 1) underwent 18F-FDG PET/CT as a part of pre-surgical staging work up. All these cases also underwent a baseline diagnostic CT of the thorax and upper abdomen, with oral and intravenous (IV) contrast. 20 of these cases underwent surgery (esophagectomy with gastric pull up) based on the PET/CT staging. Diagnostic validation was by histopathologic examination of resected specimen in the operated cases. Data was compiled and the incremental value of PET/CT over CECT for the detection of primary tumor and lymph node metastasis was assessed. The remaining 47 cases, underwent PET/CT as part of post-therapy follow up for detection of residual or recurrent disease; 18 cases (Category 2) were post-surgery (+/− chemotherapy/radiation therapy) and 29 cases (Category 3) came following conservative management (Chemotherapy/Radiotherapy/Chemo-radiotherapy) only. Data was compiled and value of PET/CT in detection of residual/recurrent disease after therapy and its ability to predict long term patient outcome was studied.
Results:
In category 1, PET/CT and CT showed concordant abnormality (locally active disease/nodal disease) in 7 cases. In 08 cases PET/CT showed positive uptake in normal sized nodes. In 03 cases CECT showed enlarged nodes which were non-FDG avid on PET/CT. In 03 cases PET/CT showed distant metastases which were not detected by CT. In category 2 recurrence at anastomotic site was detected in 1 case, disease recurrence along with distant metastases was seen in 2 cases and only residual nodal disease without a local disease was seen in 3 cases by PET/CT. Twelve cases were reported as disease free of which 10 were alive at one year (83% one year survival rate), whereas both the patients detected to have local recurrence and metastasis died within a year (one year survival rate - nil). In category 3, eight cases showed no residual disease and 21 showed metabolically active disease. Of the 08 cases shown as disease free by PET/CT, 07 survived over the next one-year period (One year survival rate 87.5%)
Conclusion:
In PET/CT, PET and CT provide complementary information and help in accurate staging, early detection of recurrence and prognostication in cases of Carcinoma Esophagus.
