Role of positron emission tomography in staging esophageal cancer

James D. Luketich, Philip R. Schauer, Carolyn Cidis Meltzer, Rodney J. Landreneau, G. Kathleen Urso, David W. Townsend, Peter F. Ferson, Robert J. Keenan, Chandra Belani

Research output: Contribution to journalArticle

176 Citations (Scopus)

Abstract

Background. Conventional noninvasive staging of esophageal cancer is inaccurate. This study investigated the role of positron emission tomography (PET) in staging esophageal cancer. Methods. Patients with potentially resectable esophageal cancer were included. A whole-body PET scan was acquired after injection of 18F-fluorodeoxyglucose and was evaluated for areas of increased focal uptake. Accuracy was determined by comparing PET with surgical staging. Results. Potentially resectable esophageal cancer was identified in 35 patients. Positron emission tomography detected nine sites of distant metastases missed by conventional scanning, but one false-negative PET scan occurred in a patient with a 2-mm liver lesion. There were 11 false- negative PET scans for small, intracapsular local-regional nodal metastases (mean diameter 5.2 mm; range 2 to 10 mm). For distant metastases, the sensitivity was 88%, the specificity was 93%, and the accuracy was 91%. For local-regional nodal metastases, the sensitivity was 45%, the specificity was 100%, and the accuracy was 48%. Conclusions. Positron emission tomography improved our ability to detect distant metastases missed by conventional noninvasive staging of esophageal cancer. Small local-regional nodal metastases are not identified by current PET technology. Early use of PET in the staging of patients with esophageal cancer could facilitate treatment planning and identifying unsuspected distant metastases in up to 20% of patients with a negative metastatic survey by conventional staging.

Original languageEnglish (US)
Pages (from-to)765-769
Number of pages5
JournalAnnals of Thoracic Surgery
Volume64
Issue number3
DOIs
StatePublished - Sep 1 1997

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Esophageal Neoplasms
Positron-Emission Tomography
Neoplasm Metastasis
Fluorodeoxyglucose F18
Technology
Injections
Liver

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Luketich, J. D., Schauer, P. R., Meltzer, C. C., Landreneau, R. J., Urso, G. K., Townsend, D. W., ... Belani, C. (1997). Role of positron emission tomography in staging esophageal cancer. Annals of Thoracic Surgery, 64(3), 765-769. https://doi.org/10.1016/S0003-4975(97)00624-3
Luketich, James D. ; Schauer, Philip R. ; Meltzer, Carolyn Cidis ; Landreneau, Rodney J. ; Urso, G. Kathleen ; Townsend, David W. ; Ferson, Peter F. ; Keenan, Robert J. ; Belani, Chandra. / Role of positron emission tomography in staging esophageal cancer. In: Annals of Thoracic Surgery. 1997 ; Vol. 64, No. 3. pp. 765-769.
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title = "Role of positron emission tomography in staging esophageal cancer",
abstract = "Background. Conventional noninvasive staging of esophageal cancer is inaccurate. This study investigated the role of positron emission tomography (PET) in staging esophageal cancer. Methods. Patients with potentially resectable esophageal cancer were included. A whole-body PET scan was acquired after injection of 18F-fluorodeoxyglucose and was evaluated for areas of increased focal uptake. Accuracy was determined by comparing PET with surgical staging. Results. Potentially resectable esophageal cancer was identified in 35 patients. Positron emission tomography detected nine sites of distant metastases missed by conventional scanning, but one false-negative PET scan occurred in a patient with a 2-mm liver lesion. There were 11 false- negative PET scans for small, intracapsular local-regional nodal metastases (mean diameter 5.2 mm; range 2 to 10 mm). For distant metastases, the sensitivity was 88{\%}, the specificity was 93{\%}, and the accuracy was 91{\%}. For local-regional nodal metastases, the sensitivity was 45{\%}, the specificity was 100{\%}, and the accuracy was 48{\%}. Conclusions. Positron emission tomography improved our ability to detect distant metastases missed by conventional noninvasive staging of esophageal cancer. Small local-regional nodal metastases are not identified by current PET technology. Early use of PET in the staging of patients with esophageal cancer could facilitate treatment planning and identifying unsuspected distant metastases in up to 20{\%} of patients with a negative metastatic survey by conventional staging.",
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Luketich, JD, Schauer, PR, Meltzer, CC, Landreneau, RJ, Urso, GK, Townsend, DW, Ferson, PF, Keenan, RJ & Belani, C 1997, 'Role of positron emission tomography in staging esophageal cancer', Annals of Thoracic Surgery, vol. 64, no. 3, pp. 765-769. https://doi.org/10.1016/S0003-4975(97)00624-3

Role of positron emission tomography in staging esophageal cancer. / Luketich, James D.; Schauer, Philip R.; Meltzer, Carolyn Cidis; Landreneau, Rodney J.; Urso, G. Kathleen; Townsend, David W.; Ferson, Peter F.; Keenan, Robert J.; Belani, Chandra.

In: Annals of Thoracic Surgery, Vol. 64, No. 3, 01.09.1997, p. 765-769.

Research output: Contribution to journalArticle

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T1 - Role of positron emission tomography in staging esophageal cancer

AU - Luketich, James D.

AU - Schauer, Philip R.

AU - Meltzer, Carolyn Cidis

AU - Landreneau, Rodney J.

AU - Urso, G. Kathleen

AU - Townsend, David W.

AU - Ferson, Peter F.

AU - Keenan, Robert J.

AU - Belani, Chandra

PY - 1997/9/1

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N2 - Background. Conventional noninvasive staging of esophageal cancer is inaccurate. This study investigated the role of positron emission tomography (PET) in staging esophageal cancer. Methods. Patients with potentially resectable esophageal cancer were included. A whole-body PET scan was acquired after injection of 18F-fluorodeoxyglucose and was evaluated for areas of increased focal uptake. Accuracy was determined by comparing PET with surgical staging. Results. Potentially resectable esophageal cancer was identified in 35 patients. Positron emission tomography detected nine sites of distant metastases missed by conventional scanning, but one false-negative PET scan occurred in a patient with a 2-mm liver lesion. There were 11 false- negative PET scans for small, intracapsular local-regional nodal metastases (mean diameter 5.2 mm; range 2 to 10 mm). For distant metastases, the sensitivity was 88%, the specificity was 93%, and the accuracy was 91%. For local-regional nodal metastases, the sensitivity was 45%, the specificity was 100%, and the accuracy was 48%. Conclusions. Positron emission tomography improved our ability to detect distant metastases missed by conventional noninvasive staging of esophageal cancer. Small local-regional nodal metastases are not identified by current PET technology. Early use of PET in the staging of patients with esophageal cancer could facilitate treatment planning and identifying unsuspected distant metastases in up to 20% of patients with a negative metastatic survey by conventional staging.

AB - Background. Conventional noninvasive staging of esophageal cancer is inaccurate. This study investigated the role of positron emission tomography (PET) in staging esophageal cancer. Methods. Patients with potentially resectable esophageal cancer were included. A whole-body PET scan was acquired after injection of 18F-fluorodeoxyglucose and was evaluated for areas of increased focal uptake. Accuracy was determined by comparing PET with surgical staging. Results. Potentially resectable esophageal cancer was identified in 35 patients. Positron emission tomography detected nine sites of distant metastases missed by conventional scanning, but one false-negative PET scan occurred in a patient with a 2-mm liver lesion. There were 11 false- negative PET scans for small, intracapsular local-regional nodal metastases (mean diameter 5.2 mm; range 2 to 10 mm). For distant metastases, the sensitivity was 88%, the specificity was 93%, and the accuracy was 91%. For local-regional nodal metastases, the sensitivity was 45%, the specificity was 100%, and the accuracy was 48%. Conclusions. Positron emission tomography improved our ability to detect distant metastases missed by conventional noninvasive staging of esophageal cancer. Small local-regional nodal metastases are not identified by current PET technology. Early use of PET in the staging of patients with esophageal cancer could facilitate treatment planning and identifying unsuspected distant metastases in up to 20% of patients with a negative metastatic survey by conventional staging.

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Luketich JD, Schauer PR, Meltzer CC, Landreneau RJ, Urso GK, Townsend DW et al. Role of positron emission tomography in staging esophageal cancer. Annals of Thoracic Surgery. 1997 Sep 1;64(3):765-769. https://doi.org/10.1016/S0003-4975(97)00624-3