title: The additional value of integrated PET/CT over PET in initial lymph node staging of esophageal cancer.
abstract: The purpose of the present study was to assess the contribution of simultaneous functional/anatomical imaging using integrated 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), compared with PET alone for the evaluation of initial lymph node staging in esophageal cancer. We studied 167 consecutive patients with thoracic esophageal squamous cell carcinoma (SCC) who had radical esophagectomy performed between January 1999 and April 2007. For individual nodal group evaluation, PET/CT showed 46.0% sensitivity (p<0.05 vs. PET), 99.4% specificity, 95.1% accuracy (p<0.05 vs. PET), 87.0% positive and 95.5% negative predictive values. PET showed 32.9% sensitivity, 98.9% specificity, 93.1% accuracy, 74.7% positive predictive value and 93.9% negative predictive value. Thus, the sensitivity and accuracy of PET/CT were significantly higher than those of PET. Comparisons between CT, PET and PET/CT in detecting lymph node metastasis by each region showed that PET/CT had a higher sensitivity in lower thoracic regions than PET and CT (p<0.05 vs. CT and PET). Lymph node staging (N0 vs. N1) was not significantly different, but staging per lymph nodal group was significantly better with PET/CT. Integrated PET/CT imaging with co-registration of anatomic and functional imaging data is useful in the initial lymph node staging of patients with operable esophageal cancer compared with PET alone.
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, Gunma, Japan. hiroyuki@po.wind.ne.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kimura
authors.forename: Masanobu
authors.initials: M
authors.lastname: Nakajima
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakai
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sano
authors.forename: Naritaka
authors.initials: N
authors.lastname: Tanaka
authors.forename: Takanori
authors.initials: T
authors.lastname: Inose
authors.forename: Ahmad
authors.initials: A
authors.lastname: Faried
authors.forename: Kana
authors.initials: K
authors.lastname: Saito
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ieta
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fukai
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Norihiro
authors.initials: N
authors.lastname: Masuda
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ojima
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Tsukada
authors.forename: Noboru
authors.initials: N
authors.lastname: Oriuchi
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*