The role of integrated computed tomography positron-emission tomography in esophageal cancer: staging and assessment of therapeutic response.
Computed tomography (CT) and endoscopy/endoscopic ultrasonography are usually performed to initially stage patients with esophageal cancer, to determine primary tumor response, and to detect nodal and distant metastases after preoperative therapy. Positron-emission tomography (PET) with [18F]-fluoro-2-deoxy-D-glucose and integrated CT-PET are useful in the initial staging of patients with esophageal cancer as well as in the prediction of pathologic response, disease-free interval, and overall survival after preoperative therapy. Importantly, integrated CT-PET imaging decreases the number of futile attempts at surgical resection, mainly because of the detection of occult distant metastases. The following sections review the use of integrated CT-PET imaging in determining the T, N, and M descriptors of the American Joint Commission on Cancer's 2002 guidelines for pathologic and clinical staging at initial diagnosis and after chemoradiation therapy in those patients being considered for surgical resection.
Erasmus
Jeremy J
JJ
Division of Diagnostic Imaging, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. jerasmus@di.mdacc.tmc.edu <jerasmus@di.mdacc.tmc.edu>
Munden
Reginald F
RF
D003287:Contrast Media; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008207:Lymphatic Metastasis; D009362:Neoplasm Metastasis / Q000175:diagnosis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
D003287:Contrast Media