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The additional value of PET/CT over PET in FDG imaging of oesophageal cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess the value of combined PET/CT compared with PET reviewed side-by-side with CT, in patients with oesophageal cancer, before and after surgery.

Methods

Forty-one FDG PET/CT studies were performed in 32 patients with oesophageal cancer, before surgery (n=18) or during follow-up after resection of the primary tumour (n=23). One hundred and fifteen sites suspicious for malignancy were evaluated. PET/CT was prospectively compared with PET reviewed side-by-side with CT, for detection, accurate localisation and characterisation of malignant sites. PET/CT performance in different anatomical regions was compared before and after surgery. The impact of fused data on patient management was retrospectively assessed.

Results

PET/CT had an incremental value over PET for interpretation of 25 of 115 sites (22%), changing the initial characterisation of ten sites to either malignant (n=1) or benign (n=9), and defining the precise anatomical location of 15 sites. PET/CT provided better specificity and accuracy than PET for detecting sites of oesophageal cancer (81% and 90% vs 59% and 83% respectively, p<0.01). Fusion was of special value for interpretation of cervical and abdomino-pelvic sites, for disease assessment in loco-regional lymph nodes before surgery and in regions of postoperative anatomical distortion. PET/CT had an impact on the further management of four patients (10%), by detecting nodal metastases that warranted disease upstaging (n=2) and by excluding disease in sites of benign uptake after surgery (n=2).

Conclusion

PET/CT improves the accuracy of FDG imaging in oesophageal cancer and provides data of diagnostic and therapeutic significance for further patient management.

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Acknowledgements

The authors thank Dr. J. Anthony Parker and Mrs. Judy Buchanan for their useful suggestions in reviewing the manuscript.

This work was supported in part by a grant from the Israeli Cancer Association.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel

    Rachel Bar-Shalom, Alex Frenkel, Zohar Keidar & Ora Israel

  2. Department of Diagnostic Imaging, Rambam Medical Center, Haifa, Israel

    Ludmila Guralnik, Max Leiderman & Diana Gaitini

  3. Department of Oncology, Rambam Medical Center, Haifa, Israel

    Medy Tsalic

  4. Technion, Israel Institute of Technology, School of Medicine, Haifa, Israel

    Diana Gaitini, Zohar Keidar & Ora Israel

  5. Department of Thoracic Surgery, Rambam Medical Center, Haifa, Israel

    Alon Ben-Nun

Authors
  1. Rachel Bar-Shalom
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  2. Ludmila Guralnik
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  3. Medy Tsalic
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  4. Max Leiderman
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  5. Alex Frenkel
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  6. Diana Gaitini
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  7. Alon Ben-Nun
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  8. Zohar Keidar
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  9. Ora Israel
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Correspondence to Rachel Bar-Shalom.

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Bar-Shalom, R., Guralnik, L., Tsalic, M. et al. The additional value of PET/CT over PET in FDG imaging of oesophageal cancer. Eur J Nucl Med Mol Imaging 32, 918–924 (2005). https://doi.org/10.1007/s00259-005-1795-y

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  • DOI: https://doi.org/10.1007/s00259-005-1795-y

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