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. 1998 Aug;78(4):521–527. doi: 10.1038/bjc.1998.526

Positron emission tomography for staging of oesophageal and gastroesophageal malignancy.

A C Kole 1, J T Plukker 1, O E Nieweg 1, W Vaalburg 1
PMCID: PMC2063088  PMID: 9716038

Abstract

Positron emission tomography (PET) with [18F]-fluoro-2-deoxy-D-glucose (FDG) was prospectively investigated as a means of detecting metastatic disease in patients with oesophageal tumours and compared with computerized tomography (CT), with the surgical findings as a gold standard. Twenty-six patients with a malignant tumour of the oesophagus or gastroesophageal junction underwent CT and PET of the chest and the abdomen. Seven patients underwent laparoscopy to establish resectability. Fifteen patients underwent laparotomy without prior laparoscopy. Four patients did not undergo surgery. The primary tumour was visualized in 81% of patients with CT and in 96% with PET. Neither CT nor PET were suited to assess the extent of wall invasion. Surgically assessed nodal status corresponded in 62% with CT and in 90% with PET. Distant metastases were found in five patients with CT and in eight with PET. The diagnostic accuracy of CT in determining resectability was 65% and for PET 88%. For CT and PET together this was 92%. The present study indicates that FDG-PET can be of importance for staging patients with oesophageal tumours. PET has a higher sensitivity for nodal and distant metastases and a higher accuracy for determining respectability than CT. PET and CT together would have decreased ill-advised surgery by 90%.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bamias A., Hill M. E., Cunningham D., Norman A. R., Ahmed F. Y., Webb A., Watson M., Hill A. S., Nicolson M. C., O'Brien M. E. Epirubicin, cisplatin, and protracted venous infusion of 5-fluorouracil for esophagogastric adenocarcinoma: response, toxicity, quality of life, and survival. Cancer. 1996 May 15;77(10):1978–1985. doi: 10.1002/(SICI)1097-0142(19960515)77:10<1978::AID-CNCR3>3.0.CO;2-D. [DOI] [PubMed] [Google Scholar]
  2. Bonavina L., Incarbone R., Lattuada E., Segalin A., Cesana B., Peracchia A. Preoperative laparoscopy in management of patients with carcinoma of the esophagus and of the esophagogastric junction. J Surg Oncol. 1997 Jul;65(3):171–174. doi: 10.1002/(sici)1096-9098(199707)65:3<171::aid-jso5>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  3. DeMeester T. R. Barrett's esophagus. Surgery. 1993 Mar;113(3):239–241. [PubMed] [Google Scholar]
  4. Delbeke D., Vitola J. V., Sandler M. P., Arildsen R. C., Powers T. A., Wright J. K., Jr, Chapman W. C., Pinson C. W. Staging recurrent metastatic colorectal carcinoma with PET. J Nucl Med. 1997 Aug;38(8):1196–1201. [PubMed] [Google Scholar]
  5. Dittler H. J., Siewert J. R. Role of endoscopic ultrasonography in esophageal carcinoma. Endoscopy. 1993 Feb;25(2):156–161. doi: 10.1055/s-2007-1010275. [DOI] [PubMed] [Google Scholar]
  6. Flanagan F. L., Dehdashti F., Siegel B. A., Trask D. D., Sundaresan S. R., Patterson G. A., Cooper J. D. Staging of esophageal cancer with 18F-fluorodeoxyglucose positron emission tomography. AJR Am J Roentgenol. 1997 Feb;168(2):417–424. doi: 10.2214/ajr.168.2.9016218. [DOI] [PubMed] [Google Scholar]
  7. Grimm H., Binmoeller K. F., Hamper K., Koch J., Henne-Bruns D., Soehendra N. Endosonography for preoperative locoregional staging of esophageal and gastric cancer. Endoscopy. 1993 Mar;25(3):224–230. doi: 10.1055/s-2007-1010297. [DOI] [PubMed] [Google Scholar]
  8. Grimm H., Hamper K., Binmoeller K. F., Soehendra N. Enlarged lymph nodes: malignant or not? Endoscopy. 1992 May;24 (Suppl 1):320–323. doi: 10.1055/s-2007-1010491. [DOI] [PubMed] [Google Scholar]
  9. Guhlmann A., Storck M., Kotzerke J., Moog F., Sunder-Plassmann L., Reske S. N. Lymph node staging in non-small cell lung cancer: evaluation by [18F]FDG positron emission tomography (PET). Thorax. 1997 May;52(5):438–441. doi: 10.1136/thx.52.5.438. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hamacher K., Coenen H. H., Stöcklin G. Efficient stereospecific synthesis of no-carrier-added 2-[18F]-fluoro-2-deoxy-D-glucose using aminopolyether supported nucleophilic substitution. J Nucl Med. 1986 Feb;27(2):235–238. [PubMed] [Google Scholar]
  11. Kemeny M. M., Hogan J. M., Ganteaume L., Goldberg D. A., Terz J. J. Preoperative staging with computerized axial tomography and biochemical laboratory tests in patients with hepatic metastases. Ann Surg. 1986 Feb;203(2):169–172. doi: 10.1097/00000658-198602000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lehr L., Rupp N., Siewert J. R. Assessment of resectability of esophageal cancer by computed tomography and magnetic resonance imaging. Surgery. 1988 Mar;103(3):344–350. [PubMed] [Google Scholar]
  13. Lightdale C. J. Endoscopic ultrasonography in the diagnosis, staging and follow-up of esophageal and gastric cancer. Endoscopy. 1992 May;24 (Suppl 1):297–303. doi: 10.1055/s-2007-1010487. [DOI] [PubMed] [Google Scholar]
  14. Masurin V. S., Ryndin V. D., Efimov O. N., Allahverdjian A. S. Surgery of localized cardioesophageal cancer. Semin Surg Oncol. 1992 Jan-Feb;8(1):33–36. [PubMed] [Google Scholar]
  15. Molloy R. G., McCourtney J. S., Anderson J. R. Laparoscopy in the management of patients with cancer of the gastric cardia and oesophagus. Br J Surg. 1995 Mar;82(3):352–354. doi: 10.1002/bjs.1800820322. [DOI] [PubMed] [Google Scholar]
  16. Plukker J. T., Sleijfer D. T., Verschueren R. C., Van der Graaf W. T., Mulder N. H. Neo-adjuvant chemotherapy with carboplatin, 4-epiadriamycin and teniposide (CET) in locally advanced cancer of the cardia and the lower oesophagus: a phase II study. Anticancer Res. 1995 Sep-Oct;15(5B):2357–2361. [PubMed] [Google Scholar]
  17. Rahamim J., Cham C. W. Oesophagogastrectomy for carcinoma of the oesophagus and cardia. Br J Surg. 1993 Oct;80(10):1305–1309. doi: 10.1002/bjs.1800801029. [DOI] [PubMed] [Google Scholar]
  18. Saunders H. S., Wolfman N. T., Ott D. J. Esophageal cancer. Radiologic staging. Radiol Clin North Am. 1997 Mar;35(2):281–294. [PubMed] [Google Scholar]
  19. Schattenkerk M. E., Obertop H., Mud H. J., Eijkenboom W. M., van Andel J. G., van Houten H. Survival after resection for carcinoma of the oesophagus. Br J Surg. 1987 Mar;74(3):165–168. doi: 10.1002/bjs.1800740305. [DOI] [PubMed] [Google Scholar]
  20. Siewert J. R., Dittler H. J. Esophageal carcinoma: impact of staging on treatment. Endoscopy. 1993 Jan;25(1):28–32. doi: 10.1055/s-2007-1010263. [DOI] [PubMed] [Google Scholar]
  21. Steinert H. C., Hauser M., Allemann F., Engel H., Berthold T., von Schulthess G. K., Weder W. Non-small cell lung cancer: nodal staging with FDG PET versus CT with correlative lymph node mapping and sampling. Radiology. 1997 Feb;202(2):441–446. doi: 10.1148/radiology.202.2.9015071. [DOI] [PubMed] [Google Scholar]
  22. Strauss L. G. Fluorine-18 deoxyglucose and false-positive results: a major problem in the diagnostics of oncological patients. Eur J Nucl Med. 1996 Oct;23(10):1409–1415. doi: 10.1007/BF01367602. [DOI] [PubMed] [Google Scholar]
  23. Sussman S. K., Halvorsen R. A., Jr, Illescas F. F., Cohan R. H., Saeed M., Silverman P. M., Thompson W. M., Meyers W. C. Gastric adenocarcinoma: CT versus surgical staging. Radiology. 1988 May;167(2):335–340. doi: 10.1148/radiology.167.2.3357941. [DOI] [PubMed] [Google Scholar]
  24. Tio T. L., Cohen P., Coene P. P., Udding J., den Hartog Jager F. C., Tytgat G. N. Endosonography and computed tomography of esophageal carcinoma. Preoperative classification compared to the new (1987) TNM system. Gastroenterology. 1989 Jun;96(6):1478–1486. doi: 10.1016/0016-5085(89)90515-5. [DOI] [PubMed] [Google Scholar]
  25. Valk P. E., Pounds T. R., Hopkins D. M., Haseman M. K., Hofer G. A., Greiss H. B., Myers R. W., Lutrin C. L. Staging non-small cell lung cancer by whole-body positron emission tomographic imaging. Ann Thorac Surg. 1995 Dec;60(6):1573–1582. doi: 10.1016/0003-4975(95)00752-0. [DOI] [PubMed] [Google Scholar]
  26. Vilgrain V., Mompoint D., Palazzo L., Menu Y., Gayet B., Ollier P., Nahum H., Fekete F. Staging of esophageal carcinoma: comparison of results with endoscopic sonography and CT. AJR Am J Roentgenol. 1990 Aug;155(2):277–281. doi: 10.2214/ajr.155.2.2115251. [DOI] [PubMed] [Google Scholar]
  27. Vitola J. V., Delbeke D., Sandler M. P., Campbell M. G., Powers T. A., Wright J. K., Chapman W. C., Pinson C. W. Positron emission tomography to stage suspected metastatic colorectal carcinoma to the liver. Am J Surg. 1996 Jan;171(1):21–26. doi: 10.1016/S0002-9610(99)80067-1. [DOI] [PubMed] [Google Scholar]
  28. Watt I., Stewart I., Anderson D., Bell G., Anderson J. R. Laparoscopy, ultrasound and computed tomography in cancer of the oesophagus and gastric cardia: a prospective comparison for detecting intra-abdominal metastases. Br J Surg. 1989 Oct;76(10):1036–1039. doi: 10.1002/bjs.1800761017. [DOI] [PubMed] [Google Scholar]
  29. Yasuda S., Raja S., Hubner K. F. Application of whole-body positron emission tomography in the imaging of esophageal cancer: report of a case. Surg Today. 1995;25(3):261–264. doi: 10.1007/BF00311538. [DOI] [PubMed] [Google Scholar]
  30. Yoshioka T., Takahashi H., Oikawa H., Kanamaru R. [Experimental study on the effectiveness of PET tumor images for cancer diagnosis]. Gan To Kagaku Ryoho. 1994 Feb;21(3):369–373. [PubMed] [Google Scholar]
  31. Ziegler K., Sanft C., Zeitz M., Friedrich M., Stein H., Häring R., Riecken E. O. Evaluation of endosonography in TN staging of oesophageal cancer. Gut. 1991 Jan;32(1):16–20. doi: 10.1136/gut.32.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. de Calan L., Portier G., Ozoux J. P., Rivallain B., Perrier M., Brizon J. Carcinoma of the cardia and proximal third of the stomach. Results of surgical treatment in 91 consecutive patients. Am J Surg. 1988 Mar;155(3):481–485. doi: 10.1016/s0002-9610(88)80118-1. [DOI] [PubMed] [Google Scholar]

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