Henry C. Lin MD, Presenter: Nothing to Disclose

Guiyun Wu, Abstract Co-Author: Nothing to Disclose

Although esophageal cancer is relatively uncommon, its incidence has been increasing and is often lethal. Therefore non-invasive early diagnosis and accurate staging of esophageal cancer is vital. The consensus is that FDG-PET is superior to CT in detecting distant metastasis. However, detection of regional nodal metastasis by FDG-PET is thought to be lower. The aim of the study is to investigate the value of PET/CT in the diagnosis, staging and re-staging of patients with esophageal cancer compared to PET alone.

The study population consists of 50 consecutive patients (43M, 7F: mean age 62 years) referred for initial diagnosis, staging and restaging of esophageal cancers. All patients fasted for at least four hours. Whole body PET/CT images were obtained with a PET/CT scanner (SIEMENS BIOGRAPH SENSATION 16) 45 minutes after administration of 10-15 mCi FDG. Both the PET (CT based attenuation correction) and PET/CT were read on screen independently by two physicians. Localization and malignant potential of lesions by PET alone was than compared to PET/CT.

PET/CT demonstrates Disease (+) in 40 patients, Disease (-) in 8 patients and equivocal results in two patients. PET/CT and PET demonstrate concordant result as expected in 23 patients as the only hypermetabolic lesion was at the esophagus. In two patients PET findings demonstrate only FDG uptake at the esophagus but with PET/CT adjacent nodal metastasis was identified. One patient study was read as negative with PET alone but became positive with PET/CT. In two patients both PET and PET/CT images demonstrates extensive abdominallymphadenopathy. Although the results are concordant, PET/CT demonstrates more precise anatomical localization. These findings emphasis the importance of PET/CT in accurate staging of esophageal cancer.

PET/CT is valuable in accurate staging of esophageal cancer compared to PET alone. PET/CT is most useful in evaluating patients with locoregional lymph node metastasis with adjacent primary tumor. It provides more precise anatomical localization of hypermetabolic lesions in the abdomen.

Lin, H, Wu, G, Comparison of PET and PET/CT in the Evaluation of Esophageal Cancer.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415095.html