BACKGROUND: We aimed to determine the appropriateness of adding 18F-fluorodeoxyglucose (FDG)-positronemission tomography (PET) to computed tomography (CT) and other pre-existing diagnostic imaging modalities for detecting subclinical lymph node metastasis of esophageal cancer, by comparing images from these modalities with the results of histopathological analysis. METHODS: Twenty patients who received radical surgery for squamous cell carcinoma of the esophagus were examined by PET-CT, and endoscopic ultrasound (EUS) examination before surgery. Based on these diagnostic modalities, the clinical target volume (CTV) was set as the gross tumor volume (GTV) plus a 1-cm margin. Histopathological diagnosis was performed in all patients immediately after resection. RESULTS: Fifty-three (3.0%) of 1764 nodes in the 20 patients were histopathologically positive for cancer cells. The CTV was not adequate to cover these histopathologically detected positive lymph nodes in 8 of 20 patients on CT, 5 of 20 on CT+EUS, 7 of 20 on PET-CT, and 5 of 20 on PET-CT+EUS. CONCLUSION: The detection rate of subclinical lymph node metastasis did not improve with the use of PET-CT, for either the cervical and supraclavicular, mediastinal, or abdominal regions. It is not recommended to use FDG-PET or PET-CT alone as a diagnostic tool to determine CTV if pathologically involved lymphatic regions are to be included in the CTV in the treatment protocol. The accuracy of PET-CT must be further improved in order to better detect positive nodes and improve the definition of the CTV.
BACKGROUND: We aimed to determine the appropriateness of adding 18F-fluorodeoxyglucose (FDG)-positronemission tomography (PET) to computed tomography (CT) and other pre-existing diagnostic imaging modalities for detecting subclinical lymph node metastasis of esophageal cancer, by comparing images from these modalities with the results of histopathological analysis. METHODS: Twenty patients who received radical surgery for squamous cell carcinoma of the esophagus were examined by PET-CT, and endoscopic ultrasound (EUS) examination before surgery. Based on these diagnostic modalities, the clinical target volume (CTV) was set as the gross tumor volume (GTV) plus a 1-cm margin. Histopathological diagnosis was performed in all patients immediately after resection. RESULTS: Fifty-three (3.0%) of 1764 nodes in the 20 patients were histopathologically positive for cancer cells. The CTV was not adequate to cover these histopathologically detected positive lymph nodes in 8 of 20 patients on CT, 5 of 20 on CT+EUS, 7 of 20 on PET-CT, and 5 of 20 on PET-CT+EUS. CONCLUSION: The detection rate of subclinical lymph node metastasis did not improve with the use of PET-CT, for either the cervical and supraclavicular, mediastinal, or abdominal regions. It is not recommended to use FDG-PET or PET-CT alone as a diagnostic tool to determine CTV if pathologically involved lymphatic regions are to be included in the CTV in the treatment protocol. The accuracy of PET-CT must be further improved in order to better detect positive nodes and improve the definition of the CTV.
Authors: J D Luketich; D M Friedman; T L Weigel; M A Meehan; R J Keenan; D W Townsend; C C Meltzer Journal: Ann Thorac Surg Date: 1999-10 Impact factor: 4.330
Authors: H L van Westreenen; M Westerterp; P M M Bossuyt; J Pruim; G W Sloof; J J B van Lanschot; H Groen; J Th M Plukker Journal: J Clin Oncol Date: 2004-09-15 Impact factor: 44.544
Authors: P Flamen; A Lerut; E Van Cutsem; W De Wever; M Peeters; S Stroobants; P Dupont; G Bormans; M Hiele; P De Leyn; D Van Raemdonck; W Coosemans; N Ectors; K Haustermans; L Mortelmans Journal: J Clin Oncol Date: 2000-09-15 Impact factor: 44.544
Authors: Olga Vrieze; Karin Haustermans; Walter De Wever; Toni Lerut; Eric Van Cutsem; Nadine Ectors; Martin Hiele; Patrick Flamen Journal: Radiother Oncol Date: 2004-12 Impact factor: 6.280
Authors: Trevor Leong; Craig Everitt; Kally Yuen; Sara Condron; Andrew Hui; Samuel Y K Ngan; Alexander Pitman; Eddie W F Lau; Michael MacManus; David Binns; Trevor Ackerly; Rodney J Hicks Journal: Radiother Oncol Date: 2006-03-20 Impact factor: 6.280
Authors: Jari V Räsänen; Eero I T Sihvo; M Juhani Knuuti; Heikki R I Minn; Markku E S Luostarinen; Pekka Laippala; Tapio Viljanen; Jarmo A Salo Journal: Ann Surg Oncol Date: 2003-10 Impact factor: 5.344
Authors: Milan Vosmik; Jiri Petera; Igor Sirak; Miroslav Hodek; Petr Paluska; Jiri Dolezal; Marcela Kopacova Journal: World J Gastroenterol Date: 2010-11-28 Impact factor: 5.742
Authors: Begoña Caballero Perea; Antonio Cabrera Villegas; José Miguel Delgado Rodríguez; María José García Velloso; Ana María García Vicente; Carlos Huerga Cabrerizo; Rosa Morera López; Luis Alberto Pérez Romasanta; Moisés Sáez Beltrán Journal: Rep Pract Oncol Radiother Date: 2012-11-17