Document Detail


Impact of the introduction of integrated PET-CT into the preoperative staging pathway of patients with potentially operable oesophageal carcinoma.
MedLine Citation:
PMID:  18555034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
H M Salahudeen; A Balan; K Naik; S Mirsadraee; A F Scarsbrook
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Publication Detail:
Type:  Journal Article     Date:  2008-04-11
Journal Detail:
Title:  Clinical radiology     Volume:  63     ISSN:  0009-9260     ISO Abbreviation:  Clin Radiol     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-16     Completed Date:  2008-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  765-73     Citation Subset:  IM    
Affiliation:
Department of Radiology, Leeds General Infirmary, St George Street, Leeds LS1 3EX, UK.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / pathology,  radionuclide imaging,  surgery
Adult
Aged
Carcinoma / pathology*,  radionuclide imaging*,  surgery
Carcinoma, Squamous Cell / pathology,  radionuclide imaging,  surgery
Esophageal Neoplasms / pathology*,  radionuclide imaging*,  surgery
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Male
Middle Aged
Neoplasm Staging / methods
Positron-Emission Tomography / methods*
Preoperative Care
Prognosis
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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