title: Position of positron emission tomography and other imaging diagnostic modalities in esophageal cancer.
abstract: Positron emission tomography (PET) using the positron emitting glucose analogue 18F-fluorodeoxyglucose (FDG) has emerged as a useful metabolism-based wholebody imaging tool for gastro-esophageal cancer diagnosis and follow up. Most large cancer centers worldwide are now equipped for PET (or even PET-CT). Therefore, there is a growing need for a clear definition of the relative position of PET within the currently available diagnostic modalities. Significant scientific data indicate that FDG-PET adds clinically useful information to the information obtained by standard means (mainly CT and endoscopic ultrasound) throughout the different phases of clinical patient management: 1) at initial diagnosis: PET detects more frequently distant lymph node involvement and organ metastases compared to conventional diagnostics, allowing a more accurate selection of the most appropriate treatment; 2) during chemotherapy: semi-quantitative FDG-PET allows early identification of non-responding patients. Indeed, the metabolic response as measured by serial FDG-PET can be used to predict the clinical and histopathological response. Moreover, the PET-response seems to be related to overall and disease free survival; 3) after a treatment: FDG-PET allows accurate assessment of the residual tumor load; 4) in the follow up: FDG-PET allows accurate detection and restaging of recurrent disease.
authors.affiliation: Department of Nuclear Medicine, University Hospital Leuven, Leuven, Belgium. Patrick.Flamen@bordet.be
authors.forename: P
authors.initials: P
authors.lastname: Flamen
authors.forename: T
authors.initials: T
authors.lastname: Lerut
authors.forename: K
authors.initials: K
authors.lastname: Haustermans
authors.forename: E
authors.initials: E
authors.lastname: Van Cutsem
authors.forename: L
authors.initials: L
authors.lastname: Mortelmans
mesh_terms: D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D019788:Fluorodeoxyglucose F18; D006801:Humans; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18