| Can hybrid FDG-PET/CT detect subclinical lymph node metastasis of esophageal cancer appropriately and contribute to radiation treatment planning? A comparison of image-based and pathological findings. | |
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MedLine Citation:
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PMID: 19856050 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We aimed to determine the appropriateness of adding 18F-fluorodeoxyglucose (FDG)-positronemission tomography (PET) to computed tomography (CT) and other pre-existing diagnostic imaging modalities for detecting subclinical lymph node metastasis of esophageal cancer, by comparing images from these modalities with the results of histopathological analysis. METHODS: Twenty patients who received radical surgery for squamous cell carcinoma of the esophagus were examined by PET-CT, and endoscopic ultrasound (EUS) examination before surgery. Based on these diagnostic modalities, the clinical target volume (CTV) was set as the gross tumor volume (GTV) plus a 1-cm margin. Histopathological diagnosis was performed in all patients immediately after resection. RESULTS: Fifty-three (3.0%) of 1764 nodes in the 20 patients were histopathologically positive for cancer cells. The CTV was not adequate to cover these histopathologically detected positive lymph nodes in 8 of 20 patients on CT, 5 of 20 on CT+EUS, 7 of 20 on PET-CT, and 5 of 20 on PET-CT+EUS. CONCLUSION: The detection rate of subclinical lymph node metastasis did not improve with the use of PET-CT, for either the cervical and supraclavicular, mediastinal, or abdominal regions. It is not recommended to use FDG-PET or PET-CT alone as a diagnostic tool to determine CTV if pathologically involved lymphatic regions are to be included in the CTV in the treatment protocol. The accuracy of PET-CT must be further improved in order to better detect positive nodes and improve the definition of the CTV. |
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Authors:
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Shinichi Shimizu; Masao Hosokawa; Kazuo Itoh; Masahiro Fujita; Hiroaki Takahashi; Hiroki Shirato |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2009-10-25 |
Journal Detail:
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Title: International journal of clinical oncology / Japan Society of Clinical Oncology Volume: 14 ISSN: 1437-7772 ISO Abbreviation: Int. J. Clin. Oncol. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-26 Completed Date: 2010-01-07 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 9616295 Medline TA: Int J Clin Oncol Country: Japan |
Other Details:
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Languages: eng Pagination: 421-5 Citation Subset: IM |
Affiliation:
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Department of Radiology, Hokkaido University, Graduate School of Medicine, Kita-Ku, Sapporo, Japan. sshimizu-rad@umin.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carcinoma, Squamous Cell / diagnosis*, radiotherapy, secondary, surgery Endosonography Esophageal Neoplasms / diagnosis*, radiotherapy, secondary, surgery Esophagectomy Female Fluorodeoxyglucose F18 / diagnostic use* Humans Lymph Nodes / radiography*, radionuclide imaging*, ultrasonography Lymphatic Metastasis Male Middle Aged Patient Selection Positron-Emission Tomography* Predictive Value of Tests Radiopharmaceuticals / diagnostic use* Radiotherapy Planning, Computer-Assisted Sensitivity and Specificity Tomography, X-Ray Computed* |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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