Impact of the introduction of integrated PET-CT into the preoperative staging pathway of patients with potentially operable oesophageal carcinoma

H M Salahudeen, A Balan, K Naik, S Mirsadraee, A F Scarsbrook

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: To retrospectively evaluate the role of integrated positron emission tomography computed tomography (PET-CT) in oesophageal carcinoma staging, in predicting prognosis and its influence on surgical management.

MATERIALS AND METHODS: Twenty-five consecutive patients with potentially operable, biopsy-proven oesophageal malignancy who undergoing PET-CT from September 2004 to April 2007 were included in this study. Chi-square and Fisher's exact tests were used to compare the accuracy of N staging with PET-CT and CT/endoscopic ultrasound (EUS) using postoperative loco-regional nodal histology as the reference standard. The prognostic value of primary tumour maximum standardized uptake value (SUVmax) was derived using logistic regression.

RESULTS: Seventeen men and eight women with a mean age of 62 years were studied. All tumours showed abnormal 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) uptake. Fifteen patients underwent surgical resection. There was high concordance between N staging at CT/EUS (14/15) and final histology. PET-CT N staging was discordant with final nodal histology in over half of the patients (8/15). PET-CT detected occult metastases in three patients (12%) that were not identified on CT and new synchronous tumours in two patients (8%). Patient management was altered in 10 patients (40%) as a direct result of PET-CT. No statistically significant association was observed between SUVmax and clinical outcome (p=0.65).

CONCLUSION: Integrated PET-CT has a significant incremental value over conventional staging investigations mainly in the detection of distant metastases and synchronous tumours and frequently impacts on patient management.

Original languageEnglish
Pages (from-to)765-73
Number of pages9
JournalClinical Radiology
Volume63
Issue number7
DOIs
Publication statusPublished - Jul 2008

Keywords

  • Adenocarcinoma
  • Adult
  • Aged
  • Carcinoma
  • Carcinoma, Squamous Cell
  • Esophageal Neoplasms
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Preoperative Care
  • Prognosis
  • Radiopharmaceuticals
  • Retrospective Studies
  • Tomography, X-Ray Computed

Fingerprint

Dive into the research topics of 'Impact of the introduction of integrated PET-CT into the preoperative staging pathway of patients with potentially operable oesophageal carcinoma'. Together they form a unique fingerprint.

Cite this