| 18F-FDG PET-Detected Synchronous Primary Neoplasms in the Staging of Esophageal Cancer: Incidence, Cost, and Impact on Management. | |
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MedLine Citation:
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PMID: 23154472 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE: F-Fluorodeoxyglucose positron emission tomography (F-FDG PET) imaging is increasingly the standard of care in the staging of esophageal cancer. Synchronous neoplasms may be identified, and this study evaluated the prevalence of such tumors and their impact on management. METHODS: Five hundred ninety-one (73.6%) of 803 consecutive patients with biopsy-proven esophageal cancer underwent staging F-FDG PET or PET/CT scans. F-FDG-avid lesions were considered synchronous primary neoplasms if occurring at locations atypical for metastases from the known primary, a marked discordance in the F-FDG avidity from that of the primary tumor, and if there was no prior detection on conventional imaging. Additional investigations as appropriate were undertaken, and histopathological verification was obtained where possible to validate the suspected synchronous neoplasm. RESULTS: A synchronous neoplasm was suspected in 55 (9.3%) of 591 patients, predominantly at sites in the colon (26) and head and neck (21). Additional investigations in 43 cases revealed malignant neoplasms in 8 (18.6%), premalignant in 9 (20.9%), and benign lesions in 26 (60.5%) cases. The management plan was altered in 8 patients, 1.4% overall. The total cost of added tests was $27,482.57 (&OV0556;21,024) with the decision to treat the esophageal cancer deferred by a mean of 10.7 days. CONCLUSION: F-FDG uptake concerning for synchronous neoplasms is evident in approximately 1 in 10 cases, and of these a minority will represent a malignant neoplasm that significantly impacts on treatment. The overall added costs per patient are relatively modest and the treatment delay within acceptable limits of clinical practice. |
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Authors:
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Vinod Malik; Ciaran Johnston; Claire Donohoe; Zieta Claxton; Julie Lucey; Narayanasamy Ravi; John V Reynolds |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical nuclear medicine Volume: 37 ISSN: 1536-0229 ISO Abbreviation: Clin Nucl Med Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-11-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7611109 Medline TA: Clin Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 1152-8 Citation Subset: IM |
Affiliation:
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From the *Department of Surgery, and †Department of Radiology, St James's Hospital and Trinity College, Dublin; and ‡Department of Nuclear Medicine, Blackrock Clinic, Dublin, Ireland. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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