Additional benefit of ¹⁸F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer.
OBJECTIVE
¹⁸F-fluorodeoxyglucose positron emission tomography (FDG PET) has been shown to improve the accuracy of staging in oesophageal cancer. We assessed the benefit of PET/CT over conventional staging and determined if tumour histology had any significant impact on PET/CT findings.


METHODS
A retrospective cohort study, reviewing the results from 200 consecutive patients considered suitable for radical treatment, undergoing routine PET/CT staging comparing the results from CT and endoscopic ultrasound, as well as multi-disciplinary team records. Adenocarcinoma and squamous cell carcinoma were compared for maximum Standardised Uptake Value (SUV(max)), involvement of local lymph nodes and distant metastases.


RESULTS
PET/CT provided additional information in 37 patients (18.5%) and directly altered management in 34 (17%): 22 (11%) were upstaged; 15 (7.5%) were downstaged, 12 of whom (6%) received radical treatment. There were 11 false negatives (5.5%) and 1 false positive (0.5%). SUV(max) was significantly lower for adenocarcinoma than squamous cell carcinoma (median 9.1 versus 13.5, p = 0.003).


CONCLUSIONS
Staging with PET/CT offers additional benefit over conventional imaging and should form part of routine staging for oesophageal cancer. Adenocarcinoma and squamous cell carcinoma display significantly different FDG-avidity.
Gillies
R S
RS
Department of Medical Oncology, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, UK. rgillies@doctors.org.uk
Middleton
M R
MR
Maynard
N D
ND
Bradley
K M
KM
Gleeson
F V
FV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
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