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Surgery Today

, Volume 44, Issue 7, pp 1258–1265 | Cite as

Diagnostic value of 18F-FDG PET/CT for lymph node metastasis of esophageal squamous cell carcinoma

  • Hiroyuki YamadaEmail author
  • Masao Hosokawa
  • Kazuo Itoh
  • Toshinao Takenouchi
  • Yoshihiro Kinoshita
  • Tomohiro Kikkawa
  • Keita Sakashita
  • Shion Uemura
  • Yasunori Nishida
  • Takaya Kusumi
  • Shigeyuki Sasaki
Original Article

Abstract

Purpose

This study investigated the diagnostic accuracy of hybrid positron-emission tomography/computed tomography (PET/CT) for lymph node (LN) metastasis of esophageal cancer. We also investigated the correlation between the size of metastatic nests and the detection by PET/CT.

Methods

Two hundred and fifty-eight patients with esophageal squamous cell carcinoma who underwent esophagectomy with two- or three-field radical lymphadenectomy were analyzed retrospectively. We compared the diagnosis of preoperative PET/CT to the postoperative histopathological examination by each anatomical field (n = 1,231) in all 258 patients. The metastatic LNs resected from PET/CT positive fields were classified as belonging to the PET/CT-N-positive group (n = 229) and those from negative fields as belonging to the PET/CT-N-negative group (n = 352). The cross-sectional areas of metastatic nests were measured in each metastatic LN.

Results

Of the 1,231 fields, 275 (22 %) were positive for metastasis, including 581 LNs from 408 regional LN stations. The sensitivity and specificity of PET/CT examined by each anatomical field were 25.8 and 97.8 %, respectively. The median area of metastatic nests was 17.7 mm2 in the PET/CT-N-positive group, and 7.7 mm2 in the PET/CT-N-negative group (p < 0.001).

Conclusions

A significant correlation was suggested between the nest size and detection by PET/CT. Because of its low sensitivity, PET/CT alone is insufficient to determine the surgical procedures, especially when considering reduction surgery.

Keywords

PET/CT Esophageal cancer Lymph node metastasis Diagnosis Squamous cell carcinoma 

Notes

Conflict of interest

We declare no potential conflicts of interest in association with this study.

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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Hiroyuki Yamada
    • 1
    Email author
  • Masao Hosokawa
    • 1
  • Kazuo Itoh
    • 2
  • Toshinao Takenouchi
    • 3
  • Yoshihiro Kinoshita
    • 1
  • Tomohiro Kikkawa
    • 1
  • Keita Sakashita
    • 1
  • Shion Uemura
    • 1
  • Yasunori Nishida
    • 1
  • Takaya Kusumi
    • 1
  • Shigeyuki Sasaki
    • 4
  1. 1.Department of Digestive SurgeryKeiyukai Sapporo HospitalSapporoJapan
  2. 2.Center of Radiological ImageKeiyukai Sapporo HospitalSapporoJapan
  3. 3.Department of Surgical PathologyKeiyukai Sapporo HospitalSapporoJapan
  4. 4.Division of Medical ScienceHealth Sciences University of HokkaidoHokkaidoJapan

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