Literature DB >> 24435775

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

Punit Sharma1, Sachin Jain, Sellam Karunanithi, Sujoy Pal, Pramod Kumar Julka, Sanjay Thulkar, Arun Malhotra, Chandrasekhar Bal, Rakesh Kumar.   

Abstract

PURPOSE: To evaluate the role of (18)F-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 (18)F-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 (18)F-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 (18)F-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).(18)F-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: (18)F-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.

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Year:  2014        PMID: 24435775     DOI: 10.1007/s00259-013-2664-8

Source DB:  PubMed          Journal:  Eur J Nucl Med Mol Imaging        ISSN: 1619-7070            Impact factor:   9.236


  29 in total

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