Does PET/CT give incremental staging information in cancer oesophagus compared to CECT?

• Main Author: Gihan Hassan Gamal
• Format: Article
• Language: English
• Published: SpringerOpen 2019-12-01
• Series: The Egyptian Journal of Radiology and Nuclear Medicine
• Subjects: Esophageal cancer; 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT); Contrast-enhanced computed tomography (CECT); Standard uptake value (SUV)
• Online Access: https://doi.org/10.1186/s43055-019-0114-8

Abstract Background The purposes of this study were to evaluate the efficiency of (18F-FDG) positron emission tomography/computed tomography (PET/CT) in diagnosing and staging of esophageal cancer and to compare the results with that of contrast-enhanced computed tomography (CECT) using the histopathological diagnosis as a gold standard. Results This is a prospective study of 19 patients from June 2017 to June 2019 (17 male, 2 female) with mean age of 68 years with newly clinical, and pathologically proven esophageal carcinoma were included in this study, all patients underwent CECT followed by PET/CT imaging as an attempt of proper staging of carcinoma. It was found that PET/CT has changed the stage group of 8 patients out of 19. Six of 8 patients were upstaged on the basis of PET/CT findings while 2 of 8 were downstaged. The statistical results of CECT in regional lymph nodes sensitivity, specificity, PPV, NPV, and accuracy were 53%, 95%, 82%, 80%, and 82% while those of PET/CT were 68%, 82%, 68%, 82%, and 79%, respectively. As regards the distant metastasis, the sensitivity, specificity, PPV, NPV, and accuracy of PET/CT were 100%, 83%, 96%, 100%, and 96% versus 73%, 100%, 100%, 50%, and 79% for CECT. Conclusion As an important diagnostic method, FGD-PET/CT showed a great impact on initial tumor staging of the patient with esophageal cancer and on the ability to detect distant metastases missed by CECT. Thus, leading to a change in clinical management of a significant number of patients.