[The value of positron emission tomography in the diagnosis and treatment of oesophageal cancer].
Fludeoxyglucose positron emission tomography (FDG-PET) is a noninvasive imaging technique that applies the glucose metabolism to visualise the metabolic activity ofa tumour. FDG-PET might improve the selection of potentially curable patients with oesophageal cancer in addition to state-of-the-art conventional work-up (e.g. endoscopic ultrasonography and spiral CT). The additional value however is only 4% for all patients, and 7% in patients with stage III-IV disease. Moreover, the additional costs of FDG-PET are not compensated by the cost reduction ofprevented surgery. To improve the outcome of patients with oesophageal cancer the value ofneoadjuvant chemo- and/or radiotherapy is being investigated. FDG-PET seems to be a promising tool for the early assessment of response to neoadjuvant therapy. In case of non-response the ineffective neoadjuvant therapy can be stopped without further delaying appropriate surgery. FDG-PET might be able to improve the prediction of prognosis, in addition to commonly used histopathological factors.
Omloo
J M T
JM
Academisch Medisch Centrum/Universiteit van Amsterdam, G4-141, Meibergdreef 9, 1105 AZ Amsterdam. j.m.omloo@amc.uva.nl
Westerterp
M
M
Sloof
G W
GW
Hoekstra
O S
OS
van Lanschot
J J B
JJ
D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care; D049268:Positron-Emission Tomography / Q000191:economics / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017211:Treatment Failure
D019275:Radiopharmaceuticals