[논문]The utility of positron emission tomography for the diagnosis and staging of recurrent esophageal cancer

Flamen, P.; Lerut, A.; Van Cutsem, E.; Cambier, J.P.; Maes, A.; De Wever, W.; Peeters, M.; De Leyn, P.; Van Raemdonck, D.; Mortelmans, L.

doi:10.1067/mtc.2000.110464

[해외논문] The utility of positron emission tomography for the diagnosis and staging of recurrent esophageal cancer 원문보기

The Journal of thoracic and cardiovascular surgery, v.120 no.6, 2000년, pp.1085 - 1092

Flamen, P. (Departments of Nuclear Medicine, Internal Medicine, Radiology, and Thoracic Surgery, University Hospital Gasthuisberg, Katholieke Universiteit Leuven (KUL), Leuven, Belgium) , Lerut, A. (Departments of Nuclear Medicine, Internal Medicine, Radiology, and Thoracic Surgery, University Hospital Gasthuisberg, Katholieke Universiteit Leuven (KUL), Leuven, Belgium) , Van Cutsem, E. (Departments of Nuclear Medicine, Internal Medicine, Radiology, and Thoracic Surgery, University Hospital Gasthuisberg, Katholieke Universiteit Leuven (KUL), Leuven, Belgium) , Cambier, J.P. (Departments of Nuclear Medicine, Internal Medicine, Radiology, and Thoracic Surgery, University Hospital Gasthuisberg, Katholieke Universiteit Leuven (KUL), Leuven, Belgium) , Maes, A. (Departments of Nuclear Medicine, Internal Medicine, Radiology, and Thoracic Surgery, University Hospital Gasthuisberg, Katholieke Universiteit Leuven (KUL), Leuven, Belgium) , De Wever, W. (Departments of Nuclear Medicine, Internal Medicine, Radiology, and Thoracic Surgery, University Hospital Gasthuisberg, Kathol) , Peeters, M. , De Leyn, P. , Van Raemdonck, D. , Mortelmans, L.

Abstract ▼ AI-Helper

AbstractObjective: To study the utility of whole-body positron emission tomography with 18F-fluoro-deoxy-D -glucose (FDG-PET) for the evaluation of recurrence after curative resection of cancer of the esophagus or gastroesophageal junction. Methods: Forty-one patients with a clinical or radiologic suspicion of recurrent disease underwent conventional diagnostic work-up, including a spiral computed tomographic scan, an endoscopic ultrasound, and a dedicated whole-body FDG-PET. PET lesions were classified as equivocal or suspicious recurrence. The conventional diagnostic work-up and PET findings were correlated with pathology or with radiologic and clinical follow-up. Equivocal lesions were classified as positive. Results: Forty recurrences were found in 33 patients. The lesions were perianastomotic (n = 9), regional (n = 12), and at distant sites (n = 19). For the diagnosis of a perianastomotic recurrence, the sensitivity, specificity, and accuracy of FDG-PET were 100%, 57%, and 74%, versus 100%, 93%, and 96% for conventional diagnostic work-up, respectively (P = not significant). False-positive PET lesions were found in patients with a progressive anastomotic stenosis requiring repetitive endoscopic dilatation. For the diagnosis of regional and distant recurrences, the sensitivity, specificity, and accuracy of PET were 94%, 82%, and 87%, versus 81% (P = not significant), 82% (P = not significant), and 81% (P = .0771) for conventional diagnostic work-up. All false-positive PET lesions (n = 4) had been reported as equivocal. On a patient base, PET provided additional information in 11 of 41 (27%) patients. A major impact on diagnosis was found in 5 patients with equivocal or negative findings on complete diagnostic work-up in whom PET provided a true-positive diagnosis. In 5 other patients the diagnosis was staged upward from localized to extended recurrent disease, and in 1 patient with an equivocal complete diagnostic work-up, PET correctly excluded malignancy. Conclusion: FDG-PET allows a highly sensitive diagnosis and accurate whole-body staging of symptomatic recurrent esophageal cancer. Further studies in asymptomatic patients are needed to assess the potential benefit on survival. (J Thorac Cardiovasc Surg 2000;120:1085-92)

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