Better assessment of nodal metastases by PET/CT fusion compared to side-by-side PET/CT in oesophageal cancer.
BACKGROUND
Recently, positron emission tomography/computed tomography (PET/CT) has been introduced in the staging of oesophageal cancer. The impact of PET/CT fusion in comparison with side-by-side PET/CT in these tumours, was analyzed.


METHODS
In 61 patients, 18-F-fluorodeoxyglucose (FDG)-PET and multidetector (md)-CT were performed within a two week interval. Software-fusion of md-CT and FDG-PET was correlated with side-by-side FDG-PET/CT reading by two independent investigators. The gold standard was the pathological outcome or clinical evidence of progression during the first year of follow-up.


RESULTS
In 18 patients (18/61; 30%), nodal staging improved with software-fusion. The number of nodal metastases increased in five patients and decreased in four patients, leading to up-staging in one patient (2%) and down-staging in three patients (5%). In nine cases (15%), certainty and localization of metastases improved. However, the number of distant metastases did not change and software-fusion did not have an influence on resectability.


CONCLUSIONS
PET/CT fusion substantially improves detection and localization of nodal metastases and may have an impact on locoregional treatment options.
Schreurs
Liesbeth M
LM
Deparments of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Pultrum
Bareld B
BB
Koopmans
Klaas P
KP
Verhoef
Christian C
CC
Jager
Pieter L
PL
Van Dam
Gooitzen M
GM
Groen
Henk
H
Van Der Jagt
Erik J
EJ
Plukker
John Th M
JT
D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18