European Radiology

, Volume 18, Issue 12, pp 2833–2840 | Cite as

Tumour length measured on PET-CT predicts the most appropriate stage-dependent therapeutic approach in oesophageal cancer

  • Johannes B. Roedl
  • Dushyant V. Sahani
  • Rivka R. Colen
  • Alan J. Fischman
  • Peter R. Mueller
  • Michael A. Blake


To compare the accuracy of determining the most appropriate treatment approach based on a visual analysis on combined PET-CT, based on a visual analysis on PET (reviewed side-by-side with CT) and based on tumour length measurements (on PET and PET-CT). Tumour length, SUV, and the length-SUV index (length × SUV) were assessed (on PET and PET-CT) in benign oesophageal lesions (reflux oesophagitis; n = 29), in potentially curable stages of oesophageal cancer (Tis; T1-T3NxM0; curable group; n = 52), and in stages of oesophageal cancer best treated with palliative therapy (T4NxMx; TxNxM1; palliative group; n = 30). All lesions were histopathologically proven. Based on a visual analysis, PET-CT (sensitivity: 77%;specificity: 96%) was more accurate than PET (sensitivity: 67%; specificity: 89%) in assessing the appropriate treatment (curative vs. palliative). The length-SUV index was the most accurate quantitative parameter to distinguish palliative from curable stages (sensitivity: 93%; specificity: 90%) and to predict survival. The highest overall accuracy was reached when combining the results of the quantitative (length-SUV index) analysis with those of the qualitative (visual) analysis (sensitivity: 93%; specificity: 96%). Moreover, neither tumour length nor SUV can be used to distinguish reflux oesophagitis from early malignant lesions (T1 stage). Tumour length measured with PET-CT or PET is associated with stage and overall survival of oesophageal cancer and helps to guide the appropriate treatment approach.


Oesophageal cancer Staging Tumour length Positron emission tomography Computed tomography 


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Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Johannes B. Roedl
    • 1
    • 2
    • 3
  • Dushyant V. Sahani
    • 1
  • Rivka R. Colen
    • 1
    • 2
  • Alan J. Fischman
    • 2
  • Peter R. Mueller
    • 1
  • Michael A. Blake
    • 1
  1. 1.Division of Abdominal and Interventional Radiology, Department of RadiologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Division of Nuclear Medicine, Department of RadiologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  3. 3.Department of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA

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