Impact of PET/CT on radiation treatment in patients with esophageal cancer: A systematic review.
OBJECTIVE
With the advances in radiotracers, positron emission tomography/computed tomography (PET/CT) is recognized as a useful adjunct to anatomic imaging with CT, MRI and endoscopic ultrasonography (EUS). The objective of this review was to comprehensively analyze the roles of PET/CT for the radiotherapy of esophageal cancer.


METHODS
In this review, we focused on issues concerning the application of PET/CT in TNM staging, target volume delineation and response to therapy, both for the primary tumor and regional lymph nodes. Furthermore, the following questions were addressed: how does PET/CT guide appropriate treatment protocols, how does it allow accurate tumor delineation and how does it guide prognosis and future treatment decisions.


CONCLUSIONS
For the staging of esophageal cancer, PET/CT played a crucial role in exploring distant malignant lymph nodes and metastasis with high sensitivity, specificity and accuracy. PET/CT using different radiotracer provided a serial of thresholding methods based on standardized uptake value (SUV) to assist in auto-contouring the gross tumor volume (GTV). The change in SUV may offer a potential paradigm of personalized treatment to definitive chemoradiotherapy (CRT). In total, PET/CT has sought to further optimize radiotherapy treatment planning for patients with esophageal cancer.
Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
Jing
J
Lu
Department of Radiation Oncology, The 81st Hospital of PLA, Nanjing 210002, PR China.
Xiang-Dong
XD
Sun
Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
Xi
X
Yang
Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
Xin-Yu
XY
Tang
Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
Qin
Q
Qin
Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
Hong-Cheng
HC
Zhu
Department of Synthetic Internal Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China.
Hong-Yan
HY
Cheng
Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, PR China. Electronic address: sunxinchen2012@163.com.
Xin-Chen
XC
Sun
D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography
D019788:Fluorodeoxyglucose F18
Biological target; Esophageal cancer; Positron emission tomography; Radiotherapy