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Diagnostic accuracy of 18F-FDG PET/CT for detection of suspected recurrence in patients with oesophageal carcinoma

  • Punit Sharma
  • Sachin Jain
  • Sellam Karunanithi
  • Sujoy Pal
  • Pramod Kumar Julka
  • Sanjay Thulkar
  • Arun Malhotra
  • Chandrasekhar Bal
  • Rakesh KumarEmail author
Original Article

Abstract

Purpose

To evaluate the role of 18F-FDG PET/CT in the detection of recurrence in patients with oesophageal carcinoma, suspected clinically or following conventional investigations.

Methods

This was a retrospective study. Data from 180 patients (age 56.3 ± 10.4 years; 126 men, 54 women) with histopathologically proven oesophageal carcinoma (squamous cell 115, adenocarcinoma 59, neuroendocrine carcinoma 4, small cell 1, poorly differentiated 1) who had undergone 227 18F-FDG PET/CT studies for suspected recurrence were analysed. Recurrence was suspected clinically or following conventional investigations. PET/CT images were revaluated by two nuclear medicine physicians in consensus. Findings were grouped into local, nodal and distant recurrence. Results were compared to those from contrast-enhanced (CE) CT when available (109 patients). Clinical/imaging follow-up (minimum 6 months) with histopathology (when available) was taken as the reference standard.

Results

Of the 227 18F-FDG PET/CT studies,166 were positive and 61 were negative for recurrent disease. PET/CT showed local recurrence in 134, nodal recurrence in 115 and distant recurrence in 47, with more than one site of recurrence in 34. The PET/CT findings were true-positive in 153 studies, true-negative in 54, false-positive in 13 and false-negative in 7. The sensitivity of 18F-FDG PET/CT was 96 %, the specificity was 81 %, the positive and negative predictive values were 92 % and 89 %, respectively, and the accuracy was 91 %. PET/CT showed similar accuracy in patients with squamous cell carcinoma and in those with adenocarcinoma (P = 0.181).18F-FDG PET/CT was more specific than CECT (67 % vs. 21 %; P < 0.0001). PET/CT was superior to CECT for the detection of nodal recurrence (P < 0.0001), but not local recurrence (P = 0.093) or distant metastases (P = 0.441).

Conclusion

18F-FDG PET/CT shows high accuracy in the detection of suspected recurrence in patients with oesophageal carcinoma. It is more specific than and is superior to CECT in the detection of nodal recurrence.

Keywords

Oesophageal carcinoma Recurrence 18F-FDG PET/CT 

Notes

Conflicts of interest

None.

Funding

No funding was received from any organization for this study.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Punit Sharma
    • 1
  • Sachin Jain
    • 1
  • Sellam Karunanithi
    • 1
  • Sujoy Pal
    • 2
  • Pramod Kumar Julka
    • 3
  • Sanjay Thulkar
    • 4
  • Arun Malhotra
    • 1
  • Chandrasekhar Bal
    • 1
  • Rakesh Kumar
    • 1
    Email author
  1. 1.Department of Nuclear MedicineAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of Surgical GastroenterologyAll India Institute of Medical SciencesNew DelhiIndia
  3. 3.Department of Radiation OncologyAll India Institute of Medical SciencesNew DelhiIndia
  4. 4.Department of RadiodiagnosisAll India Institute of Medical SciencesNew DelhiIndia

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