The role of integrated F-18-FDG-PET scanning in the detection of M1 disease in oesophageal adenocarcinoma and impact on clinical management

J Gastrointest Surg. 2011 Dec;15(12):2127-35. doi: 10.1007/s11605-011-1686-4. Epub 2011 Oct 1.

Abstract

Introduction: The aim of this study was to evaluate the efficacy of F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) scanning in the staging of oesophageal adenocarcinoma.

Methods: One hundred four patients with biopsy-proven adenocarcinoma underwent (18)F-FDG-PET scan. FDG avid lesions were further investigated to their diagnostic conclusion.

Results: Nineteen patients (18.26%) were found to have non-loco-regional FDG uptake. Of the patients, 3.84% were found to have M1 disease and 7.69% were found to have a second primary tumour. The sensitivity and specificity of FDG-PET scanning to detect metastatic disease in our series was 57.14% and 84.53%, respectively. The overall diagnostic accuracy was 82.69%.

Conclusions: PET scanning improves staging and prevents unnecessary surgery in patients with M1 disease. It represents a good adjunct to computed tomography scanning and endoscopic ultrasound in the staging of oesophageal adenocarcinoma. The detection of asymptomatic coexisting synchronous cancers is an added benefit provided by PET scanning over similar diagnostic modalities.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Colonic Neoplasms / diagnostic imaging
  • Colonic Neoplasms / secondary
  • Colonic Neoplasms / therapy
  • Combined Modality Therapy
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / therapy
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms, Second Primary / diagnostic imaging
  • Neoplasms, Second Primary / secondary
  • Neoplasms, Second Primary / therapy
  • Positron-Emission Tomography*
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / secondary
  • Prostatic Neoplasms / therapy
  • Sensitivity and Specificity

Substances

  • Fluorodeoxyglucose F18