Journal of Gastrointestinal Surgery

, Volume 13, Issue 5, pp 868–873

The Early Use of PET-CT Alters the Management of Patients with Esophageal Cancer

  • R. N. Williams
  • S. S. Ubhi
  • C. D. Sutton
  • A. L. Thomas
  • J. J. Entwisle
  • D. J. Bowrey
Original Article

DOI: 10.1007/s11605-009-0812-z

Cite this article as:
Williams, R.N., Ubhi, S.S., Sutton, C.D. et al. J Gastrointest Surg (2009) 13: 868. doi:10.1007/s11605-009-0812-z

Abstract

Introduction

The routine use of positron emission tomography–computed tomography (PET-CT) in the staging of patients with esophageal carcinoma remains contentious, with conflicting reports of its benefit. In our unit, PET-CT has been used routinely in the staging of all patients considered for radical therapy (surgery or chemoradiotherapy). Our aim was to determine the frequency with which PET-CT influenced decision making in the management of patients with carcinoma of the esophagus or gastroesophageal junction.

Methods

CT, PET-CT, and outcome information were collected on 38 patients considered for radical therapy. Patient proformas, with and without PET-CT findings, were constructed and each independently reviewed in a randomized and blinded fashion by five multidisciplinary team members (three surgeons, two oncologists) and a treatment strategy determined.

Results

PET-CT changed the staging for ten patients (26%). This translated into a change in management decision for seven patients (18%). The concordance between individual management plans and treatment intent was 79% for CT (150 of 190 decisions) and it was 92% for PET-CT (175 of 190 decisions). Full concordance between multidisciplinary team members was 66% with CT staging and 74% with the addition of PET-CT.

Conclusion

The use of PET-CT early in the staging algorithm for esophageal carcinoma altered the staging for a quarter of patients and the management for a fifth of patients, supporting its inclusion early in the staging algorithm.

Keywords

PET-CTEsophageal cancerImagingRadionuclide scanning

Copyright information

© The Society for Surgery of the Alimentary Tract 2009

Authors and Affiliations

  • R. N. Williams
    • 1
  • S. S. Ubhi
    • 1
  • C. D. Sutton
    • 1
  • A. L. Thomas
    • 2
  • J. J. Entwisle
    • 3
  • D. J. Bowrey
    • 1
    • 4
  1. 1.Department of Surgery, Leicester Royal InfirmaryUniversity Hospital of Leicester NHS TrustLeicesterUK
  2. 2.Department of Oncology, Leicester Royal InfirmaryUniversity Hospital of Leicester NHS TrustLeicesterUK
  3. 3.Department of Radiology, Leicester Royal InfirmaryUniversity Hospital of Leicester NHS TrustLeicesterUK
  4. 4.Department of Surgery, Leicester Royal InfirmaryInfirmary SquareLeicesterUK