Radiographics 2000 May-Jun;20(3):713-23
Imaging features of primary and recurrent esophageal cancer at FDG PET.
Skehan SJ, Brown AL, Thompson M, Young JE, Coates G, Nahmias C.
Because of the poor prognosis for patients with esophageal cancer and the risks
associated with surgical intervention, accurate staging is essential for optimal
treatment planning. Positron emission tomography (PET) with
2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) is a useful adjunct to more
conventional imaging modalities in this setting. FDG PET is not an appropriate
first-line diagnostic procedure in the detection of esophageal cancer and is not
helpful in detecting local invasion by the primary tumor, and further studies
are required to determine its efficacy in the detection of local nodal
metastases. However, FDG PET is superior to anatomic imaging modalities in the
ability to detect distant metastases. Metastases to the liver, lungs, and
skeleton can readily be identified at FDG PET. In addition, FDG PET has proved
valuable in determining the resectability of disease and allows scanning of a
larger volume than is possible with computed tomography. Recurrent disease is
readily diagnosed and differentiated from scar tissue with FDG PET. In addition,
FDG PET may play a valuable role in the follow-up of patients who undergo
chemotherapy and radiation therapy, allowing early changes in treatment for
unresponsive tumors. The management of most patients with esophageal cancer can
be improved with use of FDG PET.
