Additional benefit of 18F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer (original) (raw)

Abstract

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 (SUVmax), 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%). SUVmax 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.

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Acknowledgements

This work was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre, Oxford.

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Authors and Affiliations

  1. Department of Medical Oncology, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, OX3 7LJ, UK
    R. S. Gillies & M. R. Middleton
  2. Department of Oesophagogastric Surgery, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, OX3 7LJ, UK
    R. S. Gillies & N. D. Maynard
  3. Department of Radiology, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, OX3 7LJ, UK
    K. M. Bradley & F. V. Gleeson

Authors

  1. R. S. Gillies
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  2. M. R. Middleton
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  3. N. D. Maynard
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  4. K. M. Bradley
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  5. F. V. Gleeson
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Corresponding author

Correspondence toR. S. Gillies.

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Gillies, R.S., Middleton, M.R., Maynard, N.D. et al. Additional benefit of 18F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer.Eur Radiol 21, 274–280 (2011). https://doi.org/10.1007/s00330-010-1943-z

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